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This article reports on the reaction of bone to a new family of nanocrystalline hydroxyapatite biomaterials with crystal sizes similar to those of human bone. Pure nanoapatite cylinders and organoapatite cylinders containing a synthetic nanopeptide were analyzed 28 days after implantation into the spongy bone of Chinchilla rabbits. The experimental techniques used for analysis were light microscopy, scanning electron microscopy, and transmission electron microscopy. Both implant types were well incorporated, and interface events were found to be similar to those observed on human bone surfaces with regard to resorption by osteoclast-like cells and bone formation by osteoblasts. Different types of giant cells were observed resorbing the outermost surfaces of implants. There seemed to be both dissolution of the implant and particulate biodegradation leading to less dense implant regions near the interface, whereas the bulk of the implants remained denser. Transmission electron micrographs revealed that bone bonding occurred with and without an afibrillar intervening layer. Given the biologic reaction observed, these implant materials should be suitable for bone replacement and the organoapatite form could be useful for additional functions such as the release of drugs and optimized release of antibiotics, growth factors, or other substances. The organic component can also be used to control physical properties in a bony implantation bed.

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Bioglass particles of the compositions 45s5, 52s, and 55s were implanted in the distal femoral epiphysis of rabbits. Animals were sacrificed at 7, 28, and 84 days postoperatively and specimens investigated using electron microscopy and electron dispersive X-ray analysis. The intention was to correlate the finding of different types of multinuclear giant cells (MNGC) in the center of the implantation bed with earlier hypothesized accumulated particle eluates and changed particle compositions. The distribution of Si, Na, Ca, P, O, S, and Cl throughout the implantation bed was analyzed. Bioglass particles degraded either in Si-rich remnants or in CaP-shells. MNGC of foreign body giant cell type in high numbers as well as of osteoclast-like type at later time intervals in small numbers were found on the surface of Si-rich as well as on Ca- and P-rich particle remnants. Osteoclast-like cells were detected on the particles after transformation in CaP-shells. It is concluded that the formation of different types of MNGC is determined by the composition of the substrate, that is, osteoclast-like cells develop exclusively on resorbable substrates. The absolute number of MNGC depended on the time after implantation and the solubility of the implant. Bone bonding, however, only occurred on Ca- and P-rich surfaces.

Compared to the currently clinically available bone grafting materials for alveolar ridge augmentation, there is a great demand for bioactive bone substitutes with higher resorbability, which enhance osteogenesis at the same time. This has prompted the development of a silicon-doped rapidly resorbable calcium alkali orthophosphate (Si-CAOP) and silicon-doped β-tricalcium phosphate (Si-TCP). This study evaluated the effect of these two particulate graft materials as compared to the currently clinically used β-TCP on bone formation and osteogenic marker expression after 2 weeks, 1, 3, 6, 12, and 18 months of implantation in critical size defects in the sheep scapula. Immunohistochemical analysis of collagen type I, alkaline phosphatase, and osteocalcin expression was performed on resin embedded sections. The bone and particle area fraction and the bone-biomaterial contact were determined histomorphometrically. After 2 weeks and 1 month defects grafted with Si-CAOP displayed a significantly greater bone area fraction, bone-particle-contact, osteogenic marker expression and significantly lower particle area fraction than defects grafted with Si-TCP and TCP. By 3 and 6 months all materials studied mediated excellent defect regeneration with further bone remodeling at 12 and 18 months. Taken together, Si-CAOP induced the most expeditious bone regeneration of critical size defects in the sheep scapula. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2018.

The analyzed data support the rating of femoral neck fracture as requiring the intervention of urgent early surgery, as stated in the guideline. Percutaneous screw fixation can be considered for immobile and multimorbid patients with undislocated fractures. Advantages of total hip replacement compared to hemiarthroplasty cannot be supported by the QS-NRW data.

Anterior cruciate ligament (ACL) grafts made from expanded polytetrafluorethylene (ePTFE) were examined after failure (n = 7; 3 instabilities, 2 partial ruptures, and 2 complete ruptures) to provide information about secondary fixation mechanisms via ingrowth of the different tissues. The ultrastructural evaluation clearly evidenced the existence of two main interface areas of ePTFE ACL-replacement: First, in areas without a dense cellular infiltrate there was interdigitating collagen producing a dense ePTFE-collagen network. Additionally, in a few areas of the graft/bone-tunnel interface a fibrous cartilage or bone regenerate could be demonstrated to be in contact with the prosthesis. Second, there was a dense infiltration of macrophages and multinuclear giant cells, partially containing birefringent material of implant origin, with and without a neosynovia-like reaction product, indicating a disturbance of tissue integration of the prosthesis. In areas of inflammation there was no bone development and only few collagen interdigitation with the graft material. This study provides further knowledge about mechanisms of secondary graft fixation due to tissue ingrowth. The interdigitation of collagen fibers and ePTFE filaments provides interfaces which should be at least partially resistant against load.