This study compared 3 composites made of hydroxyapatite and polyhydroxybutyrate to determine their biocompatibility, osteointegration, and osteoconduction in rabbits bone defects. Hydroxyapatite-polyhydroxybutyrate was tested in a 10:90 vol/vol ratio for composite 1, 25:75 for composite 2, and 50:50 for composite 3, whereas defects in the control group remained unfilled. Limbs were clinically and radiographically evaluated, and samples were taken 8, 45, and 90 days after surgery for histologic and histomorphometrical analysis. No significant difference was found in the clinical parameters: pain, lameness, dehiscence, infection, and edema among the 4 groups. No signs of osteolysis or periosteal reaction were observed. Bone regeneration in groups 1, 2, and 3 occurred histomorphologically similar to the control group. No inflammatory infiltrate was present on any date of observation. More bone than connective tissue was significantly found in the defects of the 3 groups on all observation dates, and the percentage of bone tissue in the interface was similar for composites 2 and 3. Bone and connective tissue were observed in pores of composites 2 and 3. Osteoclasts were found in the bone-composite interface, and multinucleated giant cells were seen on the surface of composite fragments, found among mesenchymal tissue on the 45th and 90th days. No significant difference was observed in osteoclast number among the 4 groups. In summary, composites were considered biocompatible and able to integrate to bone. They also showed signs of biodegradability, and composites 2 and 3 were osteoconductive, the first displaying best characteristics for bone substitution.
RESUMOPara avaliar o compósito hidroxiapatita-lignina na osseointegração entre implante metálico e o tecido ósseo, foram utilizados 20 coelhos adultos, nos quais foi realizada uma falha óssea na face lateral proximal de ambas as tíbias. Na tíbia esquerda, introduziu-se, no canal medular, um pino intramedular de Schanz revestido com o compósito em sua parte rosqueada, após o preenchimento daquele com 1000mg do compósito. A falha cortical foi preenchida com o compósito. O mesmo foi feito na tíbia direita, porém sem a utilização do compósito, servindo como controle. A avaliação clínica baseou-se na deiscência, claudicação, sensibilidade dolorosa e circunferência tibial. Foram realizadas radiografias imediatamente após a cirurgia e aos oito, 30, 60, 90 e 120 dias do pós-operatório. A maioria dos animais apresentou evolução clínica normal. Nas radiografias do grupo tratado, houve decréscimo da radiopacidade no defeito e no espaço medular até tornar-se semelhante à do osso circunvizinho, quadro inverso ao do grupo-controle. Conclui-se que o compósito hidroxiapatita-lignina não mostrou indícios clínicos de rejeição e que o tecido visualizado na altura da falha óssea e ao redor do pino intramedular tinha radiopacidade semelhante à do osso circunvizinho, o que sugere que o material promoveu a integração com o tecido ósseo.
The objective of this study was to evaluate the use of a lyophilized and gamma-sterilized allogeneic freeze-dried bone wedge as a spacer for advancement of a modified tibial tuberosity (mTTA) in 16 knees that were clinically diagnosed with cranial cruciate ligament disease. Patients underwent radiography before the surgical procedure as well as immediately after surgery and at 30, 60, 90 and 120 days post-surgery, and their locomotion was evaluated at the same time points except for the immediate postoperative period. The surgical wounds were evaluated for signs of infection and rejection of the bone implant. Locomotion was graded on a scale of 0–5, with 0 indicating no limping and 5 indicating limb functional impotence. The "tibial-tibial bone-tibial implant" interfaces were evaluated radiographically, and each interface was assigned scores of 0–3, with 0 indicating no contact between the implant and adjacent bone and 3 indicating a bone bridge throughout the interface. The patients showed good clinical and radiographic recovery. The lyophilized bone spacer allowed for easy storage and transport and rapid and satisfactory execution of mTTA while showing resistance to drilling and fixation with screws in 87.5% of cases and a mean surgical time of 45.9 minutes. No immunogenic reactions were observed in 93.7% of the cases. One patient presented infection of the surgical focus, which showed remission after antimicrobial therapy. All patients showed functional recovery of the operated limb, with the number of clinically healthy patients being higher than those with claudication at 120 days (p ≤ 0.05). In all patients, it was possible to verify the incorporation of the bone implant into the tibia. Bone union occurred progressively, and the degrees of bone union observed on radiographs at postoperative days 60, 90, and 120 were significantly greater (p < 0.05) than those observed in the immediate postoperative period and at 30 days.
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