Beta-tricalcium phosphate ceramic as a bone substitute in orthopaedic surgery

Abstract

Synthetic beta-tricalcium phosphate ceramic (Biosorb, S.B.M., Lourdes, France) was used as a bone substitute in 110 patients whose mean age was 48 (14-83) years. There was a wide spectrum of indications, and the material was used alone in 86, combined with a corticocancellous bone autograft in 22, and combined with a corticocancellous allograft in two. The patients were assessed clinically and radiographically. Incorporation of the ceramic was excellent in 30, good in 51, and fair in 26. There were no poor results. In three patients the implanted material was removed because of infection. Incorporation was good or excellent in about 75% of all 110 patients. We consider beta-tricalcium phosphate ceramic to be the substitute of choice for mediumsized bone defects.Résumé Nous avons utilisé du phosphate tricalcique de synthèse (Biosorb, S.B.M., Lourdes, France) comme remplaçant de l'os chez 110 malades. Leur âge moyen était 47,5 (14-83) années. Les indications ont couvert un spectre large. Le substitut a été utilisé seul dans 86 cas, combiné avec une autogreffe osseuse dans 22 cas et avec une allogreffe dans 2 cas. Les malades ont été évalués d'une manière clinique et radiographique L'incorporation a été décrite comme excellente dans 30 cas, bonne dans 51 et médiocre dans 26 cas. Il n'y avait pas d'échecs. Trois fois les implants ont été enlevés à cause d'une infection. Dans l'ensemble, l'incorporation était bonne ou excellente pour 3/4 des malades de la série. Nous considérons le phosphate tricalcique comme un sustitut de choix pour les pertes de substance osseuse de taille moyenne.

Bone substitutes: a review of their characteristics, clinical use, and perspectives for large bone defects management

“…β -tri-calcium phosphate ( β -TCP) (Ca 3 (PO 4 ) 2 ) has largely been used as a bone substitute 94 – 96 for more than 25 years, mainly for orthopedics and dentistry applications, 97 and is considered as the “gold standard” for synthetic bone. 95 It is a biocompatible 98 , 99 and bioresorbable material 8 , 58 , 94 , 100 , 101 with properties similar to the inorganic phase of bone. β -TCP is osteoconductive 96 , 98 , 102 , 103 due to its composition and its porosity, 100 which depends on the processing condition.…”

Anterior cervical fusion with a bio-resorbable composite cage (beta TCP–PLLA): clinical and radiological results from a prospective study on 20 patients

“…Tricalcium phosphate (TCP) is a completely resorbable substitute; the advantage of this ceramic is that resorption and bone healing are simultaneous (creeping substitution), leading to complete fusion and new bone formation [5,16,17,20]. However, pure TCP ceramic materials are brittle and can fracture without prior elastic deformation, leading to the formation of hard debris presenting risk of spinal cord or nerve root lesion [1].…”

“…It has proved its clinical effectiveness in many indications [5,16,17,20]. TCP is completely resorbable in variable period depending on the porosity but pure TCP ceramics are brittle materials, as any ceramic material.…”

Bone Graft Extruded From an Intramedullary Nail Tract in the Tibia

“…Mineralization occurs and the new bone undergoes remodeling [ 16 ]. Tricalcium phosphate, has been used alone [ 18 , 19 ] and has been shown to be superior to autograft in certain instances [ 20 ]. The porosity of the structure determines the surface area exposed and increases the speed of bone formation.…”