Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement
Abstract Background Reconstruction of metaphyseal fractures represents a clinical challenge for orthopedic surgeons. Especially in osteoporotic bone, these fractures are frequently accompanied by osseous substance defects. In order to ensure rapid mobilization of patients, high stability requirement...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-07-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01801-8 |
| _version_ | 1798041458080481280 |
|---|---|
| author | Alexander M. Keppler Maximilian M. Saller Alberton Paolo Westphal Ines Heidenau Frank Schönitzer Veronika Böcker Wolfgang Kammerlander Christian Schieker Matthias Aszodi Attila Neuerburg Carl |
| author_facet | Alexander M. Keppler Maximilian M. Saller Alberton Paolo Westphal Ines Heidenau Frank Schönitzer Veronika Böcker Wolfgang Kammerlander Christian Schieker Matthias Aszodi Attila Neuerburg Carl |
| author_sort | Alexander M. Keppler |
| collection | DOAJ |
| description | Abstract Background Reconstruction of metaphyseal fractures represents a clinical challenge for orthopedic surgeons. Especially in osteoporotic bone, these fractures are frequently accompanied by osseous substance defects. In order to ensure rapid mobilization of patients, high stability requirements must be met by osteosynthesis. Various bone graft materials have been introduced in the past, such as autologous bone or exogenous bone substitute materials. These are used as bone void fillers or as augmentation techniques to ensure safe fixation of osteosynthesis. New calcium phosphate-based bone void-filling materials could be a promising alternative to autologous bone or to the currently and widely used polymethylmethacrylate (PMMA)-based cement. The aim of this study was to evaluate a novel paste-like bone void filler in vivo and in vitro with regard to biocompatibility and osteoconductivity. Methods In addition to in vitro testing of cell compatibility using pre-osteoblasts (MC3T3-E1), 35 Wistar rats were treated in vivo with implantation of various material mixtures based on calcium phosphate and aluminum oxide reinforcement in a metaphyseal drill hole defect. After 4 weeks, an examination by micro-computed tomography (μCT) and histology was performed. Results The in vitro analysis showed good biocompatibility with a high cell survival of osteoblasts. In the in vivo experiments, a significantly higher bone ingrowth compared to the empty defect was shown by μCT and histological analysis. Here, the group receiving material reinforced with aluminum oxide (Al2O3) showed a bone volume/tissue volume (BV/TV) of 89.19% compared to a BV/TV of 83.14% for the empty defect (p = 0.0013). In the group treated with a polysaccharide matrix, no increase in BV/TV was observed given a mean ratio of 80.14%. Scoring of histological sections did not reveal a significant difference between CaP and CaP that was substituted with Al2O3. Conclusion The results of this study show an encouraging first step towards the development of new pasty, bone void-filling materials. We demonstrated that a new paste-like bone-filling material, based on calcium phosphate granulates and aluminum oxide to provide strength, exhibits good biocompatibility and osteoconductivity. Further biomechanical test in an osteoporotic animal model will have to be performed, to prove feasibility in metaphyseal defects. |
| first_indexed | 2024-04-11T22:21:47Z |
| format | Article |
| id | doaj.art-5212e4c26dae469f83730b7566fbebd9 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T22:21:47Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-5212e4c26dae469f83730b7566fbebd92022-12-22T04:00:05ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-07-0115111010.1186/s13018-020-01801-8Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcementAlexander M. Keppler0Maximilian M. Saller1Alberton Paolo2Westphal Ines3Heidenau Frank4Schönitzer Veronika5Böcker Wolfgang6Kammerlander Christian7Schieker Matthias8Aszodi Attila9Neuerburg Carl10Department of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichBioCer GmbHDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichDepartment of General, Trauma and Reconstructive Surgery, University Hospital of the Ludwig-Maximilians-University MunichAbstract Background Reconstruction of metaphyseal fractures represents a clinical challenge for orthopedic surgeons. Especially in osteoporotic bone, these fractures are frequently accompanied by osseous substance defects. In order to ensure rapid mobilization of patients, high stability requirements must be met by osteosynthesis. Various bone graft materials have been introduced in the past, such as autologous bone or exogenous bone substitute materials. These are used as bone void fillers or as augmentation techniques to ensure safe fixation of osteosynthesis. New calcium phosphate-based bone void-filling materials could be a promising alternative to autologous bone or to the currently and widely used polymethylmethacrylate (PMMA)-based cement. The aim of this study was to evaluate a novel paste-like bone void filler in vivo and in vitro with regard to biocompatibility and osteoconductivity. Methods In addition to in vitro testing of cell compatibility using pre-osteoblasts (MC3T3-E1), 35 Wistar rats were treated in vivo with implantation of various material mixtures based on calcium phosphate and aluminum oxide reinforcement in a metaphyseal drill hole defect. After 4 weeks, an examination by micro-computed tomography (μCT) and histology was performed. Results The in vitro analysis showed good biocompatibility with a high cell survival of osteoblasts. In the in vivo experiments, a significantly higher bone ingrowth compared to the empty defect was shown by μCT and histological analysis. Here, the group receiving material reinforced with aluminum oxide (Al2O3) showed a bone volume/tissue volume (BV/TV) of 89.19% compared to a BV/TV of 83.14% for the empty defect (p = 0.0013). In the group treated with a polysaccharide matrix, no increase in BV/TV was observed given a mean ratio of 80.14%. Scoring of histological sections did not reveal a significant difference between CaP and CaP that was substituted with Al2O3. Conclusion The results of this study show an encouraging first step towards the development of new pasty, bone void-filling materials. We demonstrated that a new paste-like bone-filling material, based on calcium phosphate granulates and aluminum oxide to provide strength, exhibits good biocompatibility and osteoconductivity. Further biomechanical test in an osteoporotic animal model will have to be performed, to prove feasibility in metaphyseal defects.http://link.springer.com/article/10.1186/s13018-020-01801-8 |
| spellingShingle | Alexander M. Keppler Maximilian M. Saller Alberton Paolo Westphal Ines Heidenau Frank Schönitzer Veronika Böcker Wolfgang Kammerlander Christian Schieker Matthias Aszodi Attila Neuerburg Carl Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement Journal of Orthopaedic Surgery and Research |
| title | Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement |
| title_full | Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement |
| title_fullStr | Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement |
| title_full_unstemmed | Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement |
| title_short | Bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement |
| title_sort | bone defect reconstruction with a novel biomaterial containing calcium phosphate and aluminum oxide reinforcement |
| url | http://link.springer.com/article/10.1186/s13018-020-01801-8 |
| work_keys_str_mv | AT alexandermkeppler bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT maximilianmsaller bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT albertonpaolo bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT westphalines bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT heidenaufrank bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT schonitzerveronika bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT bockerwolfgang bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT kammerlanderchristian bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT schiekermatthias bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT aszodiattila bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement AT neuerburgcarl bonedefectreconstructionwithanovelbiomaterialcontainingcalciumphosphateandaluminumoxidereinforcement |