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Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery.

Van Lieshout EM, Van Kralingen GH, El-Massoudi Y, Weinans H, Patka P - BMC Musculoskelet Disord (2011)

Bottom Line: Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa).The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications.The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery-Traumatology, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands. e.vanlieshout@erasmusmc.nl

ABSTRACT

Background: Many (artificial) bone substitute materials are currently available for use in orthopaedic trauma surgery. Objective data on their biological and biomechanical characteristics, which determine their clinical application, is mostly lacking. The aim of this study was to investigate structural and in vitro mechanical properties of nine bone substitute cements registered for use in orthopaedic trauma surgery in the Netherlands.

Methods: Seven calcium phosphate cements (BoneSource®, Calcibon®, ChronOS®, Eurobone®, HydroSet™, Norian SRS®, and Ostim®), one calcium sulphate cement (MIIG® X3), and one bioactive glass cement (Cortoss®) were tested. Structural characteristics were measured by micro-CT scanning. Compression strength and stiffness were determined following unconfined compression tests.

Results: Each bone substitute had unique characteristics. Mean total porosity ranged from 53% (Ostim®) to 0.5% (Norian SRS®). Mean pore size exceeded 100 μm only in Eurobone® and Cortoss® (162.2 ± 107.1 μm and 148.4 ± 70.6 μm, respectively). However, 230 μm pores were found in Calcibon®, Norian SRS®, HydroSet™, and MIIG® X3. Connectivity density ranged from 27/cm3 for HydroSet™ to 0.03/cm3 for Calcibon®. The ultimate compression strength was highest in Cortoss® (47.32 MPa) and lowest in Ostim® (0.24 MPa). Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa).

Conclusions: The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications. The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.

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Related in: MedlinePlus

Production of test samples Test samples with a height of 8 mm and a diameter of 4 mm were made using a custom-made Teflon mold (panel A). Panel B shows examples of Calcibon® test samples.
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Figure 1: Production of test samples Test samples with a height of 8 mm and a diameter of 4 mm were made using a custom-made Teflon mold (panel A). Panel B shows examples of Calcibon® test samples.

Mentions: Nine bone substitutes that were available as (injectable) paste were selected for biomechanical testing; seven calcium phosphate cements, one calcium sulphate and one bioactive glass (Table 1). The products were stored at room temperature until use. Ten to 12 cylindrical test samples were prepared per product using a custom-made Teflon mould (Dept. Experimental Medical Instrumentation, Erasmus MC, Rotterdam, the Netherlands; Figure 1). Samples had a length of 8 mm and a diameter of 4 mm. This 2:1 ratio was the optimal ratio according Hing et al [20]. Samples were allowed to harden for 20 minutes at room temperature, after which micro-CT scanning was performed. Sample density was calculated from the length, diameter and weight. Subsequently, samples were kept at 37°C for 3 days in sterile water to allow for maximal hardening, upon which a compression test was performed.


Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery.

Van Lieshout EM, Van Kralingen GH, El-Massoudi Y, Weinans H, Patka P - BMC Musculoskelet Disord (2011)

Production of test samples Test samples with a height of 8 mm and a diameter of 4 mm were made using a custom-made Teflon mold (panel A). Panel B shows examples of Calcibon® test samples.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3040718&req=5

Figure 1: Production of test samples Test samples with a height of 8 mm and a diameter of 4 mm were made using a custom-made Teflon mold (panel A). Panel B shows examples of Calcibon® test samples.
Mentions: Nine bone substitutes that were available as (injectable) paste were selected for biomechanical testing; seven calcium phosphate cements, one calcium sulphate and one bioactive glass (Table 1). The products were stored at room temperature until use. Ten to 12 cylindrical test samples were prepared per product using a custom-made Teflon mould (Dept. Experimental Medical Instrumentation, Erasmus MC, Rotterdam, the Netherlands; Figure 1). Samples had a length of 8 mm and a diameter of 4 mm. This 2:1 ratio was the optimal ratio according Hing et al [20]. Samples were allowed to harden for 20 minutes at room temperature, after which micro-CT scanning was performed. Sample density was calculated from the length, diameter and weight. Subsequently, samples were kept at 37°C for 3 days in sterile water to allow for maximal hardening, upon which a compression test was performed.

Bottom Line: Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa).The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications.The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery-Traumatology, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands. e.vanlieshout@erasmusmc.nl

ABSTRACT

Background: Many (artificial) bone substitute materials are currently available for use in orthopaedic trauma surgery. Objective data on their biological and biomechanical characteristics, which determine their clinical application, is mostly lacking. The aim of this study was to investigate structural and in vitro mechanical properties of nine bone substitute cements registered for use in orthopaedic trauma surgery in the Netherlands.

Methods: Seven calcium phosphate cements (BoneSource®, Calcibon®, ChronOS®, Eurobone®, HydroSet™, Norian SRS®, and Ostim®), one calcium sulphate cement (MIIG® X3), and one bioactive glass cement (Cortoss®) were tested. Structural characteristics were measured by micro-CT scanning. Compression strength and stiffness were determined following unconfined compression tests.

Results: Each bone substitute had unique characteristics. Mean total porosity ranged from 53% (Ostim®) to 0.5% (Norian SRS®). Mean pore size exceeded 100 μm only in Eurobone® and Cortoss® (162.2 ± 107.1 μm and 148.4 ± 70.6 μm, respectively). However, 230 μm pores were found in Calcibon®, Norian SRS®, HydroSet™, and MIIG® X3. Connectivity density ranged from 27/cm3 for HydroSet™ to 0.03/cm3 for Calcibon®. The ultimate compression strength was highest in Cortoss® (47.32 MPa) and lowest in Ostim® (0.24 MPa). Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa).

Conclusions: The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications. The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.

Show MeSH
Related in: MedlinePlus