1.Negative Effect of Rapidly Resorbing Properties of Bioactive Glass-Ceramics as Bone Graft Substitute in a Rabbit Lumbar Fusion Model.
Jae Hyup LEE ; Hyun Seung RYU ; Jun Hyuk SEO ; Do Yoon LEE ; Bong Soon CHANG ; Choon Ki LEE
Clinics in Orthopedic Surgery 2014;6(1):87-95
BACKGROUND: Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. METHODS: This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5-6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). RESULTS: In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. CONCLUSIONS: The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass-ceramics are resorbed before bony fusion.
Animals
;
Bone Resorption
;
Bone Substitutes/adverse effects/*therapeutic use
;
Ceramics/adverse effects/*therapeutic use
;
Electric Conductivity
;
Lumbosacral Region/*surgery
;
Male
;
Rabbits
;
Spinal Fusion/*methods
2.Percutaneous Vertebroplasty Using Fresh Frozen Allogeneic Bone Chips as Filler.
Dong Ki AHN ; Song LEE ; Dae Geun KIM ; Won Sik SHIN
Clinics in Orthopedic Surgery 2014;6(1):49-55
BACKGROUND: Vertebroplasty is not free from cement related complications. If an allograft is used as a filler, most of them can be averted. METHODS: Forty consecutive cases of osteoporotic vertebral fracture were divided into two groups by self-selection. The study and the control groups underwent vertebroplasty with fresh frozen allogeneic bone chips and bone cement, respectively. Clinical results were assessed at preoperation, postoperative day 1 and months 3, 6, and 12 by 10-grade visual analog scale (VAS), and radiological results were assessed at the same time by vertebral kyphotic angle (VKA) and local kyphotic angle (LKA). The results were compared within and between the groups. Survival function was analyzed. The criteria of an event were clinical or radiological deterioration versus pre-index surgery state. RESULTS: VAS was improved in the study group from 8.4 +/- 0.8 to 5.2 +/- 1.4, 6.4 +/- 1.2, 5.5 +/- 2.7, and 3.7 +/- 1.4 at postoperative day 1 and months 3, 6, and 12, respectively, and in the control group from 8.4 +/- 1.2 to 3.2 +/- 1.1, 3.2 +/- 1.7, 3.2 +/- 2.7, and 2.5 +/- 1.7, respectively (within group, p < 0.001; between groups, p < 0.001). VKA was improved in the study group from 18.9degrees +/- 8.0degrees to 15.2degrees +/- 6.1degrees (p = 0.046) and in the control group from 14.7degrees +/- 5.2degrees to 10.3degrees +/- 4.7degrees (p < 0.001) at postoperative day 1. LKA was not improved in the study group but was improved in the control group from 16.8degrees +/- 11.7degrees to 14.3degrees +/- 9.6degrees (p = 0.015). Correction angle was 2.7degrees +/- 4.6degrees, -7.9degrees +/- 5.3degrees, -7.2degrees +/- 5.2degrees, and -7.4degrees +/- 6.3degrees at postoperative day 1 and months 3, 6, and 12, respectively, in the study group and 4.3degrees +/- 3.7degrees, 0.7degrees +/- 3.6degrees, 0.7degrees +/- 4.2degrees, and 0.1degrees +/- 4.4degrees, respectively, in the control group. Correction loss was significant in both groups (p < 0.001) and more serious in the study group (p < 0.001). The 6-month survival rate was 16.7% in the study group and 64.3% in the control group (p = 0.003; odds ratio, 5.250). CONCLUSIONS: In treatment of osteoporotic vertebral fracture, fresh frozen allogeneic bone chips are not recommendable as a filler for its worse results than bone cement.
Aged
;
Bone Cements/adverse effects
;
Bone Substitutes/adverse effects
;
Case-Control Studies
;
Female
;
Humans
;
Male
;
Osteoporotic Fractures/epidemiology/*surgery
;
Pain Measurement
;
Transplantation, Homologous/adverse effects/instrumentation/*methods
;
Vertebroplasty/adverse effects/instrumentation/*methods
3.Management of the bone defects in revision total hip arthroplasty.
Chinese Journal of Surgery 2005;43(20):1309-1312
OBJECTIVETo determine the efficiency and clinical outcome of impaction bone graft in revision total hip arthroplasty (THA).
METHODSSeventy-two revision THAs by using impaction bone graft in 48 patients with severe bone loss were gotten average 25 months follow-up. Harris hip scores and X-ray were used to evaluate the results.
RESULTSThe mean Harris hip scores improved from 44.6 before operation to 87.4 after operation. The excellent and good results were 90.3%. No stem subsidence and cup migration were found. Femoral fracture rate was 4.2%, and dislocation rate was 1.4%.
CONCLUSIONImpaction bone graft is an efficacious method to restore bone stock in revision THA, and using anatomic stem and freeze-drying cancellous bone allograft could also get good clinical result.
Aged ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Bone Cements ; Bone Substitutes ; Bone Transplantation ; methods ; Female ; Follow-Up Studies ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Prosthesis Failure ; Reoperation ; Transplantation, Homologous ; Treatment Outcome
4.A clinical study on immediate implantation of particulate hydroxylapatite artificial bone after teeth extraction.
Lei LIU ; Shengwei LI ; Weidong TIAN
West China Journal of Stomatology 2002;20(1):42-44
OBJECTIVEThe aim of this study is to investigate the effect and complication of immediate implantation of particulate hydroxylapatite artificial bone after teeth extraction.
METHODSParticulate hydroxylapatite artificial bone was implanted into 65 extraction sockets after teeth extraction. All patients were followed up until 3 months after the operation. They are examined with clinical examination and X-ray examination to observe the effect and complication of the implantation operation.
RESULTSThe wound healed well in all cases without any complication. Compared to the alveolar ridge before teeth extraction, and the height of the alveolar ridge after teeth extraction didn't decrease.
CONCLUSIONImplantation of particulate hydroxylapatite artificial bone after teeth extraction could maintain the height of the alveolar ridge and reduce the complication of teeth extraction. It would be helpful for the following prosthetic restoration. The immediate implantation of artificial bone is therefore needed further study.
Adult ; Aged ; Alveolar Bone Loss ; prevention & control ; Alveolar Ridge Augmentation ; methods ; Biocompatible Materials ; Bone Substitutes ; Dental Implantation, Endosseous ; Dental Implants, Single-Tooth ; Denture, Partial, Temporary ; Female ; Humans ; Hydroxyapatites ; Male ; Middle Aged ; Tooth Extraction ; adverse effects