Evaluation of a novel nanocrystalline hydroxyapatite paste Ostim® in comparison to Alpha-BSM® - more bone ingrowth inside the implanted material with Ostim® compared to Alpha BSM®

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to evaluate the performance a newly developed nanocrystalline hydroxyapatite, OSTIM^®following functional implantation in femoral sites in thirty-eight sheep for 1, 2 or 3 months. Ostim^®35 was compared to an established calcium phosphate, Alpha BSM^®.</p> <p>Methods</p> <p>Biomechanical testing, μ-CT analysis, histological and histomorphological analyses were conducted to compare the treatments including evaluation of bone regeneration level, material degradation, implant biomechanical characteristics.</p> <p>Results</p> <p>The micro-computed tomography (μCT) analysis and macroscopic observations showed that Ostim^®seemed to diffuse easily particularly when the defects were created in a cancellous bone area. Alpha BSM^®remained in the defect.</p> <p>The performance of Ostim was good in terms of mechanical properties that were similar to Alpha BSM^®and the histological analysis showed that the bone regeneration was better with Ostim^®than with Alpha BSM^®. The histomorphometric analysis confirmed the qualitative analysis and showed more bone ingrowth inside the implanted material with Ostim^®when compared to Alpha BSM ^®at all time points.</p> <p>Conclusions</p> <p>The successful bone healing with osseous consolidation verifies the importance of the nanocrystalline hydroxyapatite in the treatment of metaphyseal osseous volume defects in the metaphyseal spongiosa.</p

Treatment of tibial plateau fractures with high strength injectable calcium sulphate

The aim of this article is to discuss the clinical efficacy of high strength injectable calcium sulphate (MIIGX3) in the treatment of tibial plateau fractures. Thirty-one patients with tibial plateau fractures treated with MIIGX3 were included. Postoperative radiographic study was used to evaluate congruity of the articular surface, bone regrowth, and the absorption process of MIIGX3. Rasmussen’s score system was adapted for the postoperative knee function recovery assessment. Twenty-eight of 31 patients were followed-up successfully with an average follow-up length of 14.6 months. Complete fracture healing was found in all patients. Complications included wound exudation and articular subsidence. Postoperative knee function was good according to Rasmussen’s score system. Six months after surgery, radiographs demonstrated equivalent bone density in the previous area of MIIGX3 as that of surrounding cancellous bone. The use of MIIGX3 in the treatment of tibial plateau fractures provides adequate intraoperative stability and improves the safety of early knee motion

Prospective study of standalone balloon kyphoplasty with calcium phosphate cement augmentation in traumatic fractures

Prospective consecutive series cases study to investigate the clinical and radiological results of standalone balloon kyphoplasty and cement augmentation with calcium phosphate in traumatic fractures. Independent observer evaluation of radiological and computer tomography results, visual analogue scale (VAS), Roland–Morris score and complications with acute traumatic compression fractures type A, treated with a standalone balloon kyphoplasty and cement augmentation with calcium phosphate (Calcibon™); follow-up time at a mean of 30 months (24–37 months). From August 2002 to August 2003, consecutive patients with traumatic compression fractures (Magerl type A) without neurological deficit underwent standalone kyphoplasty with Calcibon. We report here the pre-, post-operative and the follow-up results, applying the VAS (0–10) for pain rating, the Roland–Morris (0–24) disability score, CT-scan examination, detailed radiographic evaluation of vertebral body (VB) deformity and segmental kyphosis measurement. The pre-operative X-ray measurements, VAS and the 7 days Roland–Morris scores are compared with the post-operative and the 30 months follow-up findings. Twenty-eight patients with 33 treated fracture levels were included in this study. The mean initial vertebral deformity (VB kyphosis) was 17°, corrected to a post-operative of 6°. We noted a loss of correction at the follow-up in comparison to the post-operative standing X-ray at 24 h of 3° vertebral deformity and 3° segmental kyphosis. The VAS score demonstrates a decrease over time from a mean of 8.7–3.1 at 7 days and to 0.8 at the last follow-up. The Roland–Morris disability score demonstrates a similar improvement. We noticed no major complications related to the procedure. The mean cement resorption after 1 year was 20.3% (0.3–35.3%) and is related to the individual biological resorption process and is not predictable. All patients with vertebral fractures as sole medical problem were discharged within 48 h. All active patients returned to the same work within 3 months with the same working ability as before the accident. Standalone balloon kyphoplasty is a potential alternative mini-invasive technique to reduce the fractures. However, due to the intrinsic characteristic of calcium phosphate cement (Calcibon) we recommend the application of this biological cement for standalone reduction and stabilisation only in fractures type A1 and A3.1 in young patient. In case of higher destruction levels of the VB, we propose the utilisation of Calcibon associated with posterior instrumentation. Having regard to the pointed out indications, our preliminary results demonstrate a new possibility to treat this kind of fractures, allowing a rapid handling of pain, early discharge and return to normal activities