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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

Compression strength of bone substitutes The compression strength was determined using unconfined compression tests as described in the Materials and Methods. Each dot represents an individual test sample, and lines indicate the average value. The table below the figure shows the outcome of the pairwise comparisons (Student's T-test with Bonferroni correction). *, p < 0.05; **, p < 0.01; ***, p < 0.005; ns, not statistically significantly different. Grey boxes represent the self-self combinations, which could not be tested.
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Figure 8: Compression strength of bone substitutes The compression strength was determined using unconfined compression tests as described in the Materials and Methods. Each dot represents an individual test sample, and lines indicate the average value. The table below the figure shows the outcome of the pairwise comparisons (Student's T-test with Bonferroni correction). *, p < 0.05; **, p < 0.01; ***, p < 0.005; ns, not statistically significantly different. Grey boxes represent the self-self combinations, which could not be tested.

Mentions: The compression strength of all products was determined using unconfined compression tests. Cortoss® had the highest ultimate compression strength (47.32 ± 20.34 MPa; see Figure 8). This was statistically significantly higher than the strength of all other products. Next in order of diminishing strength were Calcibon® and Norian SRS® (33.95 ± 6.75 and 25.64 ± 7.37 MPa, respectively), which was statistically significantly higher than most other products. ChronOS® and Ostim® had poor compression strengths (0.81 ± 0.32 and 0.24 ± 0.05 MPa, respectively).


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)

Compression strength of bone substitutes The compression strength was determined using unconfined compression tests as described in the Materials and Methods. Each dot represents an individual test sample, and lines indicate the average value. The table below the figure shows the outcome of the pairwise comparisons (Student's T-test with Bonferroni correction). *, p < 0.05; **, p < 0.01; ***, p < 0.005; ns, not statistically significantly different. Grey boxes represent the self-self combinations, which could not be tested.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 8: Compression strength of bone substitutes The compression strength was determined using unconfined compression tests as described in the Materials and Methods. Each dot represents an individual test sample, and lines indicate the average value. The table below the figure shows the outcome of the pairwise comparisons (Student's T-test with Bonferroni correction). *, p < 0.05; **, p < 0.01; ***, p < 0.005; ns, not statistically significantly different. Grey boxes represent the self-self combinations, which could not be tested.
Mentions: The compression strength of all products was determined using unconfined compression tests. Cortoss® had the highest ultimate compression strength (47.32 ± 20.34 MPa; see Figure 8). This was statistically significantly higher than the strength of all other products. Next in order of diminishing strength were Calcibon® and Norian SRS® (33.95 ± 6.75 and 25.64 ± 7.37 MPa, respectively), which was statistically significantly higher than most other products. ChronOS® and Ostim® had poor compression strengths (0.81 ± 0.32 and 0.24 ± 0.05 MPa, respectively).

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