Biocompatible Bone Fillers

Pelvic Osteolysis

Felicia Shay

Computer Integrated Surgery II

Bone Filler Ingrowth

Bibliography: Papers

• S. Takaaki, M. Saito, K. Kawagoe, et al. “New hydroxyapatite composite resin as a bioactive bone cement: improvement of handling and mechanical properties.” Bioceramics. Vol. 11 (1998): World Scientific Publishing Co. Pte. Ltd, 251-254.

• W. F. Mousa, M. Kobayashi, S. Shinzator, et al. “Biological and mechanical properties of commercial PMMA bone cements containing AW-GC filler” Bioceramics. Vol. 12 (1999): World Scientific Publishing Co. Pte. Ltd, 545-548.

• Y. Okada, K. Kawanabe, H. Fujita, et al. “Bonding behavior of bioactive bone cement in segmental replacement of rabbit tibia: comparison with PMMA bone cement.” Bioceramics. Vol. 12 (1999): World Scientific Publishing Co. Pte. Ltd, 529-533.

Bibliography: Continued

• N. Asaoka, M. Misago, M. Hirano, et al. “Mechanical and chemical properties of the injectable calcium phosphate cement.” Bioceramics. Vol. 12 (1999): World Scientific Publishing Co. Pte. Ltd, 525-528.

• F.C.M. Dreissens, M.G. Boltong, E.A.P. de Maeyer, et al. “Comparative Study of Some Experiemental or Commercial Calcium Phosphate Bone Cements.” Bioceramics. Vol 11 (1998): World Scientific Publishing Co. Pte. Ltd, 231-234

Test Materials/Composition

• PMMA

• PMMA Composites

• Bioglass

• PMMA/ Ca/P Composites

• Ca/P Composites

• Hydroxyapatite

Background

• Fundamental of:– PMMA– Ca/P– Bioglass

• Uses

• Ideal

Methods of Testing

• Cyclic Wear: Compression• Tension: Figure 1• X-ray Diffraction: Analyze reaction• Scanning Electron Microscope

(SEM): Microstructure• Injectability• Setting time

Comparison of Ca/P Materials

Time (I)

Time

(F)

C

(M Pa)

Cement Ca/P

Immerse Ca/P

TCP

CaCO3

6.5 (0.5)

8.5 (0.5)

33 (5) 1.705 1.672

HA 9.5 (0.25)

17.0 (1.0)

8 (2) 1.746 1.616

HA

CaCO3

2.75

(0.25)

7.5 (0.5)

48 (3) 1.513 1.481

Bioglass 6.25 (0.25)

10.0 (0.5)

32 (4) N/A N/A

Compressive Strength

Type of Material Compressive Strength (MPa) and Day

TCP Composite 60 MPa (4 days)

70 MPa (7 days)

AP and CaCO3 33 MPa (1 day)

Hydroxyapatite 8 MPa (1 day)

HA, DCP, CaCo3 48 MPa (1 day)

PMMA based 125 MPa (1 day)

Bioactive vs PMMA: after time

PMMA in Rat Tibia: 8 weeks

Weaknesses

• Lack of:– In vivo testing for some experiences– Long term testing for analysis– Testing of different porousity– Uniform testing for all types of materials

• Dependency upon:– Mixing– P/L ratio dependent

Strengths

• Uniform Testing methods

• In vivo like environments

• Good comparison of materials

• Length of testing

• Different:– Composites– P/L ratios

Results/Discussion

• Results

• Interpretation

• Inconsistencies

• Overlapping

• Resolution

• Additional studies