The kinetics of remodeling of a calcium sulfate/calcium phosphate bioceramic

Abstract

In the last years considerable research and development activity have been expended to find new ceramic bone substitutes for the treatment of bone defects. However in many cases the drawback of synthethic bone substitutes are the slow graft incorporation and remodelling into the host bone. The purpose of this study was to analyze the kinetics of resorption and new bone formation of new calcium sulfate (CaSO)/calcium phosphate (CaPO) bioceramic engineered to enhance its bone forming properties. We prospectively evaluated the results of a series of 15 hips with osteonecrosis of the femoral head (ONFH) treated at with core decompression and injection of the CaSO/CaPO composite. In all hips, a quantitative computed tomography (QTC) scan was taken within one week after the surgery, at 12 months, 2 years and finally with a minimum of 4 years follow-up. The mean HU in the immediate post-operative period was 1445 (Range 1388-1602); At one year the mean HU strongly decrease at 556.6 HU (P < 0.01); The mean HU at 2 years follow-up further decreased to 475.1. The mean HU at 4 years was unchanged. The quantitative and qualitative CT scan data of this series indicates that the CaSO-CaPO ceramic composite resorbs over a narrow timeframe and the gradual resorption of the graft within the defect provides an ideal environment for the direct new bone growth that propagates across the defect.

In vitro and in vivo effectiveness of a novel injectable calcitonin-loaded collagen/ceramic bone substitute

“…Some synthetic bone graft substitutes are not easily to be absorbed by the host, resulting in delayed bone healing. To overcome this drawback, Civinini et al 12 developed a biocompatible and bioresorbable calcium sulfate/calcium phosphate bioceramic, which has been shown to promote bone healing in patients with osteonecrosis of the femoral head (ONFH). In addition, calcium sulfate/calcium phosphate composite bone cements have been designed to locally deliver antibiotics to treat bone infection with good results in rabbits and rats.…”

“…9 Calcium phosphates are the major inorganic components of the bone. Therefore, a variety of calcium phosphates derivatives, including hydroxyapatite, 6 tri-calcium phosphate, 6 calcium phosphate cement, 10 calcium sulfate, 11 and calcium sulfate/calcium phosphate, 12 have been utilized to generate biocompatible and absorbable bone graft cements. For example, NuROs injectable bone graft substitute is a commercially available bone cement with a porous interconnect structure, and can be used to fill into bone defect.…”

The Treatment of Acute Diaphyseal Long-bones Fractures with Orthobiologics and Pharmacological Interventions for Bone Healing Enhancement: A Systematic Review of Clinical Evidence

“…Overall complications rates were similar; however, the rate of infection was higher in the autograft group than that in the collagen-ceramic graft group (13% vs. 4.9%). The application of bioactive glass showed promising results [47]. Sun et al in an RCT, compared the use of reamed IMN alone versus reamed IMN combined with Bioglass 45S5 grafting at the fracture sites for the treatment of 78 tibial diaphyseal fractures.…”

Tetracalcium Phosphate/Monetite/Calcium Sulfate Hemihdrate Biocement Powder Mixtures Prepared by the One-Step Synthesis for Preparation of Nanocrystalline Hydroxyapatite Biocement-Properties and In Vitro Evaluation

“…The rise in cement solubility with enhanced release of calcium from the cement improves the bioactivity of cement in relation to osteoinduction [ 8 ]. Another possibility for improvement of TTCPM bioactivity is addition of more soluble inorganic components, which actively influence cell behavior after the application of cements; from this point of view, the addition of a complex amino acid mixture or arginine-glycine-aspartate (RGD) [ 9 , 10 ], the preparation of TTCPM/magnesium phosphate composite cements with more soluble magnesium components [ 11 ], substitution of HAP with sulfate ions [ 12 ], and CS/CPC composites [ 13 ] represent cheap and simple examples of studied biocements. Calcium sulfate in the form of hemihydrate (CSH) has been used as a cheap, synthetic, non-toxic, and bioactive bone filler over 100 years.…”