The objective of the study is to determine the current tendencies in the use of osteoplastic materials based on tricalcium phosphate (TCP) in orthopedics and traumatology. Methods. The search of the scientific information for the analysis was carried out in the PubMed, Google Scholar, World Digital Library, ScienceDirect. Results. The development of biomaterials for reconstructive surgery on the skeleton remains an urgent issue of biomaterial engineering, biology and current traumatology and orthopedics. Calcium-phosphate ceramics have the excellent properties of biocompatibility, affinity with bone tissue, biodegradability as well as perfect osteoconductive and osteointegrative properties. They are used in orthopaedics and traumatology as a coating for endoprosthesis components in order to achieve a strong bond with the bone as well as a filling material for bone defects in the form of blocks, granules or powder. The optimal structure of ceramic materials in order to achieve the necessary hardness and control of the dissolution rate is still undetermined. The interest of researchers in the creation of osteoplastic materials containing TCP is explained by the advanced osteoinductive properties and the ability to quickly degrade with the formation of bone tissue. Due to different configurations and sizes of the bone defects, the creation of a material with osteoinductive and osteoconductive properties that could be inserted into the cavity in a liquid state and which would quickly harden and acquire the properties similar to those of the bone has been of great current interest. The material should be biodegradable while having sufficient time for bone formation at the implantation site. In view of the above, the creation of cements based on calcium phosphates has become more attractive. Unfortunately, this material is limited in use due to its brittleness and insufficient hardness. Certain reinforcing additives are expected to significantly improve the mechanical properties of the cement. It is desirable that these particles should have bioactive properties analogous to those of cement. A slight modification of the material can significantly change its properties, which makes it imperative to investigate experimentally the biological properties of the investigated material.
Endoprosthesis of large joints is an efficient method to restore the functional capacity of a limb, to increase the patientʼs motor activity, to eliminate the pain syndrome and to recover self-service. However, there is a risk of certain complications, one of which is massive blood loss. There have been recent publications on the feasibility of the use of tranexamic acid in the arthroplasty of large joints to prevent and reduce blood loss. The objective is to identifythe trends in the use of tranexamic acid in orthopedics and traumatology to prevent blood loss in the arthroplasty of large joints without increasing the risk of other complications. Methods. The search for the scientific information was conducted in Google Scholar, PubMed, World Digital Library, ScienceDirect. Results. The literature review is devoted to the topical issue of the present dayʼs orthopedics, which is the use of tranexamic acid to prevent bloodloss in arthroplasty of large joints. According to the studies, the use of tranexamic acid significantly reduces the overall blood loss without increasing the risk of complications such as thromboembolism. The risk of complications of infectious genesis and of those due to the blood transfusion is also reduced using tranexamic acid. It is determined that the combined intra-articular and intravenous injection of tranexamic acid is more efficient than the applicationof either method separately. However, the comparative results of the ways of administration and the dosage regimen are quite ambiguous. The question of the optimum dose of the medication, which would provide maximum efficiency, without increasing the risk of complications is still to establish. It is advisable to conduct further research on the use of tranexamic acid to determine the efficiency of the ways of injection, dosing regimen taking into accountthe patients' demographic features, their age, concomitant pathology, time of surgery and other factors.
Calcium phosphatCalcium phosphate cement (CPC) is a material used to fill bone defects. Its advantages include being able to fill irregularly shaped spaces, its similarity to bone tissue, and ease of biodegradation. However, insufficient durability and unpredictable rate of resorption limit CPC use. Objective. Study the dynamics of morphological changes in rat femurs after implanting two types of CPC based on metastable αʹ‒tricalcium phosphate(αʹ‒TCP) into defects in the distal metaphysis. Methods. 42 male white rats were used in the study. In each rat, defects were created in the distal metaphysis of the left femur and filled with one of the two types of CPC. The animals were split into two groups: І (n = 21) — CPC based on αʹ‒TCP powder; ІІ (n = 21) — CPС based on αʹ‒TCP powder reinforced with hydroxyapatite (HA) whiskers (4 % mass). Both varieties of CPC were developed and prepared at the Department of Solid-State Physics at the V. N. Karazin Kharkiv National University (Ukraine). 14, 30, and 60 days after the surgery, the animals were sacrificed, and histological analyses were performed. Results. For both types of CPC, inflammation was not observed in the region around the implant at 14, 30, or at 60 days. Bone tissue formed on the surface of the materials. The stages of bone repair were similar to the known stages of bone repair. As a result of the resorption of the CPC, 60 days after surgery the CPC comprised 26.83 % of the area of the defect in group I and 29.93 % in group II. The rest of the area was composed of lamellar bone. The two groups did not differ significantly in rate of CPC resorption or bone tissue formation. Conclusions. The two types of CPC studied, based on αʹ‒TCP (group I) and αʹ‒TCP reinforced with HA whiskers (group II), are biocompatible, osteoconductive, and osteoinductive. In addition, these materials are biodegradable and, with time, are replaced by bone tissue.
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