The bioactive glass known as Bioglass or Perioglass (USB) (US Biomaterials, Alachua, FL) has proven to be an effective graft material owing to the apatite layer which forms on the surface of the glass, promoting bone formation. USB particles range in size from 90 to 710 microns in diameter, as determined by optical microscopy. A similar bioactive material, BioGran (OV) (Orthovita, Malvern, PA), was developed to limit the particle size of 4555 to the range between 300 and 360 microns, as determined by sieving. The objective of this study was to histologically and biomechanically compare the 4555 bioactive glass, produced by US Biomaterials, in a wide particle range (USB) to the narrower particle range glass produced by Orthovita (OV) The grafted defects will then be compared to normal cancellous bone (NORM) of the distal femur in rabbits. Histologically, more bone was quantified at both 4 and 12 weeks within the defects filled with USB and NORM when compared to the limbs filled with OV (p< 0.05). The OV particles had greater particle axes and larger particle areas on average than the USB particles (p < 0.05). However, the particle axis and area of the two materials decreased with time at a similar rate. Biomechanically, the USB- and OV-grafted defects had comparable peak compressive load, compressive stiffness, and compressive modulus which were equivalent to normal bone.

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Peak load in the failure test was not found to be statistically different between the two-hole and four-hole designs. In cyclic testing, the two-hole configuration exhibited statistically smaller fragment migration in both shear and distraction than the four-hole design (p < 0.05). The strain magnitude in the side plate was not statistically different in the cyclic or failure tests. The femurs with a greater neck angle failed by crushing of the bone in the neck. The femurs with a lesser neck angle failed due to bending of the hardware. The results of this investigation revealed that the two-hole DHS is biomechanically as stable as the four-hole DHS in cyclic and failure loads under the conditions tested. These results, in concert with clinical experience, can be used to support the use of the two-hole DHS for the reconstruction of intertrochanteric fractures without a diaphyseal extension.