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Non-setting, injectable biomaterials containing particulate hydroxyapatite can increase primary stability of bone screws in cancellous bone

Munoz, Jorge Solana (författare)
Ecole Polytech Fed Lausanne, Inst Bioengn, Lab Biomech Orthoped, Lausanne, Switzerland
Kettenberger, Ulrike (författare)
Ecole Polytech Fed Lausanne, Inst Bioengn, Lab Biomech Orthoped, Lausanne, Switzerland
Procter, Philip (författare)
Uppsala universitet,Tillämpad materialvetenskap
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Pioletti, Dominique P. (författare)
Ecole Polytech Fed Lausanne, Inst Bioengn, Lab Biomech Orthoped, Lausanne, Switzerland
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 (creator_code:org_t)
Elsevier BV, 2018
2018
Engelska.
Ingår i: Clinical Biomechanics. - : Elsevier BV. - 0268-0033 .- 1879-1271. ; 59, s. 174-180
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background: Fracture fixation in weak bone is still a clinical challenge. Screw augmentation was shown to successfully increase their primary stability. The currently used calcium phosphate or polymeric bone cements, however, present important drawbacks such as induced toxicity and/or impaired bone neo-formation. A new approach to enhance bone screw primary stability without affecting bone formation is the use of non-setting, calcitim phosphate loaded soft materials as the augmentation material. Methods: Two types of biomaterials (non-crosslinked hyaluronic acid as viscous fluid and agar as hydrogel) were loaded with 40 wt/vol% of hydroxyapatite particles and characterized. The screw augmentation effect of all materials was evaluated through pull-out tests in bovine cancellous bone and compared to the non-augmented situation (control). The bone mineral density of each test sample was measured with CT scans and was used to normalize the pull-out strength. Findings: Both materials loaded with hydroxyapatite increased the normalized pull-out strength of the screws compared to control samples and particle-free materials. This counter-intuitive augmentation effect increased with decreasing bone mineral density and was independent from the type of the soft materials used. Interpretation: We were able to demonstrate that non-setting, injectable biomaterials loaded with ceramic particles can significantly enhance the primary stability of bone screws. This material combination opens the unique possibility to achieve a screw augmentation effect without impairing or even potentially favoring the bone formation in proximity to the screw. This effect would be particularly advantageous for the treatment of osteoporotic bone fractures requiring a stabilization with bone screws.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinsk bioteknologi -- Biomaterialvetenskap (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Medical Biotechnology -- Biomaterials Science (hsv//eng)

Nyckelord

Weak bone quality
Screw augmentation
Soft material
Hydrogel
Primary stability
Osteoporosis

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