Calcium phosphate ceramic has been known for its properties of bioactivity and osteoconductivity and has been widely used in orthopedic, plastic and craniofacial surgeries. The biocompatibility, unlimited availability, lower morbidity for the patient and cost-effectiveness of calcium phosphate ceramics represent important advantages over other biological bone graft, such as autografts and allografts. A new synthetic biphasic calcium phosphate (BCP), Bicera™ (60% HA and 40% β-TCP), is manufactured by Wiltrom Co., Ltd., as a new bone graft substitute. It shows good biocompatibility without cytotoxicity in in vitro test. To evaluate the possible application for clinical use, we used New Zealand white rabbit femur defect model to compare the osteoconductivity of this new bone substitute to another commercially available bone substitute (Triosite®) which was used as the control material. According to the macroscopic observation, both bone substitutes show good biocompatibility and no abnormal inflammation either infection was seen at the implantation sites. X-rays image of implant sites at one month, three months and six months showed all implanted materials were well incorporated with host bone. All of them were not fully absorbed and replaced after six months implantation. In the histological and hitomorphometric data, new bone grew into the surface of the peripheral pores in both bone substitutes and increased over time. Moreover, the degree of bone regeneration appeared to be relatively greater in the specimens with Bicera™ when compared with Triosite®. We concluded that this new synthetic BCP (Bicera™) showed similar biocompatibility and osteoconductive characteristic comparing with commercial product Triosite® in rabbit femur defects model.
Calcium phosphate ceramics, of a similar composition to that of mineral bone, and which possess the properties of bioactivity and osteoconductivity, have been widely used as substitutes for bone graft in orthopedic, plastic and craniofacial surgeries. A synthetic β-tricalcium phosphate, Osteocera™, a recently developed bone graft substitute, has been used in this study. To evaluate the affinity and efficacy of Osteocera™ as bone defect implant, we used a New Zealand white rabbit femur defect model to test the osteoconductivity of this new bone substitute. Alternative commercially available bone substitutes, Triosite® and ProOsteon500, were used as the control materials. These three bone substitutes show good biocompatibility, and no abnormal inflammation either infection was seen at the implantation sites. In the histological and histomorphometric images, newly formed bone grew into the peripheral pores in the bone substitutes. After six months implantation, the volume of bone formation was found to be 20.5 ± 5.2%, 29.8 ± 6.5% and 75.5 ± 4.9% of the potential total cavity offered by ProOsteon500, Triosite® and Osteocera™, respectively. The newly formed bone area within the femur defect section for Osteocera™ was significantly larger than ProOsteon500 and Triosite®. We concluded that Osteocera™ shows better bioresorbability, biocompatibility and osteoconductivity in the rabbit femur defect model.
From July 1990 to June 1993, 35 patients suffering lumbar spondylolisthesis (21 degenerative; 14 isthmic) were operated on and reviewed. They all had single-level involvement either L4-5 or L5-S1 and only this level was confined for operation. The operative procedures included decompression, posterolateral fusion and pedicle screw instrumentation for fixation and reduction of the vertebral slip. The age ranged from 42 to 65 years old, with an average of 55 years. There were 21 patients with grade 1 slip; 13 with grade II; and 1 with grade III. The follow-up periods ranged from 30 to 55 months with an average of 42 months. The clinical results were evaluated according to the improvement of low back pain, radicular pain, claudication and the incidence of fusion. Twenty-four patients (74%) were rated good to excellent and the fusion rate was 88%. However, there were 16 patients who still suffered from significant low back pain and who had reportd that such pain adversely affected the rating of clinical result. Loss of reduction were found in 16 patients, but there was no difference in clinical outcome between patients with or without reduction loss after the operation. The purpose of this paper is to report the clinical outcomes of the treatment of symptomatic spondylolisthesis with decompression, posterolateral fusion and instrumental reduction of the slip. The incidence of reduction loss and the prevalence of remaining low back pain are two important factors to consider in doing such reduction procedure. We inferred that slip reduction may not be a worthwile procedure in the treatment of adult spondylolisthesis if ordinary posterolateral fusion with short segment instrumentation is contemplated.
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