Ceramic-Plastic Material as a Bone Substitute

Smith, L.W.

doi:10.1097/00003086-199209000-00002

Cited by 13 publications

(8 citation statements)

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“…Since the introduction of ceramics for the replacement of bone, 21 26 Many authors have reported that metal implants coated with HA achieve rapid surface bone apposition with good stability [16][17][18] and HA has been packed into massive bone defects in revised total hip arthroplasties by Oonishi et al 27 There have been few reports in the English literature on the clinical application of HA in surgery for bone tumours. In our series, HA was well incorporated into the surrounding host bone in all cases within a mean period of 4.2 months.…”

Section: Discussionmentioning

confidence: 99%

Use of hydroxyapatite to fill cavities after excision of benign bone tumours

Yamamoto

Onga

Marui

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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Much of the basic research on calcium hydroxyapatite (HA) has concerned its clinical use as a bone-graft substitute. Biological, 1,2 histological 3-12 and biomechanical surveys of its implantation into bone [13][14][15] reveal that the material is safe and has excellent osteoconductive properties. It is often used as a coating for prostheses as well as to fill bone defects. [16][17][18] There have, however, been few reports on the outcome of its clinical use in surgery for bone tumours. 19,20 Since 1988, we have implanted HA for bone defects after resection of benign bone tumours. Patients and MethodsWe analysed the outcome in 75 patients with benign bone tumours. There were 28 women and 47 men, with a mean age of 27.7 years (3 to 80). All the lesions were imaged by plain radiography, CT and MRI. All patients had curettage of the tumour and filling of the resulting bone defect with HA, without autologous bone. Cortical fenestration was carried out using an osteotome and the intraosseous tumours were removed by a curette. When sclerotic margins were present they were drilled to establish a connection to healthy bone marrow. After filling the bone defect with HA, the cortical window was replaced. No other adjuvant treatment such as phenol or cryotherapy was used after curettage. Internal fixation was not employed. External stabilisation with splints or slings was utilised postoperatively for patients judged to be at risk of pathological fracture. The tumours were located in the femur (26 patients), phalanx or metacarpal (18), tibia (11), humerus (9), calcaneus (4), pelvis (3), radius or ulna (3) and fibula (1). Histological examination revealed that 21 were enchondromas, 18 fibrous dysplasias, 12 non-ossifying fibromas, eight solitary bone cysts, six Langerhans-cell histiocytomas, three chondroblastomas, two giant-cell tumours of bone, one aneurysmal bone cyst, one intraosseous haemangioma, one osteofibrous dysplasia, one osteoid osteoma and one enostosis (bone island).We used an HA compound ([Ca 10 (PO 4 ) 6 (OH) 2 ]) with tricalcium phosphate (TCP) in a ratio of 70% HA to 30% TCP (Chugai Inc, Tokyo, Japan). The porosity was 3% to 55% and the pore size 1 to 15 m. The sintering temperature ranged from 900° to 1300°C, and the bending strength from 50 to 800 kg/cm 2 . Variously shaped pieces of HA were used in the operations, depending on the location and size of the tumour. The mass of implanted HA ranged from 3 to 55 g. After surgery radiographs were assessed according to the criteria of Uchida et al 19 to determine changes in the radiolucent zone around the HA and the amount of incorporation and displacement of HA. Postoperative CT was carried out on some patients. The mean follow-up was 41 months (5 to 140). Of the 30 patients with lesions of the upper limb, 24 were immobilised in a sling or a splint. All 18 patients with lesions in the phalanges and metacarpals had splints. The mean period of immobilisation was 3.5 weeks. Of the 42 patients with lesions in the lower limb, six were immobilised in splints. The me...

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Section: Discussionmentioning

confidence: 99%

Use of hydroxyapatite to fill cavities after excision of benign bone tumours

Yamamoto

Onga

Marui

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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“…In the 1960s, Cerosium, a porous calcium aluminate ceramic impregnated with an epoxy resin, was introduced and was considered to be the first porous material mechanically strong enough to be considered in orthopaedic load-bearing applications [68]. While Cerosium carried a stiffness closer to that of bone, its suboptimal pore size did not promote bone ingrowth, and ultimately this material was not utilized clinically.…”

Section: Brief History Of Porous Orthopaedic Implantsmentioning

confidence: 99%

“…This titanium fiber-metal composite material demonstrated improved biomaterial properties, including sufficient strength, a relatively high level of porosity (in the range of 40-50 %), and a large range of elastic strain [69]. During this same time period, other researchers developed and advanced the technology of porous cobaltchromium (CoCr) surfaces for use as coatings in orthopaedic implants, many of which form the basis for use in today's orthopaedic industry [68,[73][74][75][76][77][78][79][80][81][82][83][84][85][86].…”

Section: Brief History Of Porous Orthopaedic Implantsmentioning

confidence: 99%

Modern Porous Coatings in Orthopaedic Applications

Frank

Fabi

Levine

2013

Biological and Medical Physics, Biomedical Engineering

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The development of porous metals and coatings for orthopaedic applications has revolutionized the medical field. The ability to bond metallic implants to bone has spawned the advancements in total joint arthroplasty we have experienced over the last 4 decades. Early success was obtained as factors (pore size, coefficient of friction, modulus of elasticity) necessary for osseointegration were just being discovered. Despite good results, initial implant designs were fabricated utilizing traditional coatings (i.e. sintered beads, fiber metal, plasma spray), which have several inherent limitations, including relatively high moduli of elasticity, low coefficient of frictions and intermediate porosity. In order to improve upon these limitations and capitalize on modern techniques for implant fabrication several new porous metals have been recently introduced in orthopaedics. Tritanium (Stryker, Mahwah, NJ), Regenerex (Biomet, Warsaw, IN), StikTite (Smith and Nephew, Memphis, TN), Gription (Depuy, Warsaw, IN), Biofoam (Wright Medical, Arlington, TX), and Trabecular Metal (Zimmer, Warsaw, IN) are currently available for orthopaedic surgery applications. These materials have moved us into the era metallic foams that possess a characteristic appearance similar to cancellous bone. The open-cell internal structure of these metals afford several interesting biomaterial properties, including; high volumetric porosity (60-80 %), low modulus of elasticity and high surface frictional characteristics. The following chapter reviews the mode of fabrication, properties and applications in orthopaedic surgery for this new class of highly porous metals.

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“…33 Hulbert et al 34 demonstrated that porous disks of a near inert ceramic exhibited thinner fi brous encapsulation with faster healing in surrounding muscle and connective tissue than dense disks, as a result of a mechanical interlock which reduced motion between host tissue and implant.…”

Section: 4mentioning

confidence: 99%

Biomimetic bone regeneration

Hing¹

2013

Biomimetic Biomaterials

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Ceramic-Plastic Material as a Bone Substitute

Cited by 13 publications

References 0 publications

Use of hydroxyapatite to fill cavities after excision of benign bone tumours

Use of hydroxyapatite to fill cavities after excision of benign bone tumours

Modern Porous Coatings in Orthopaedic Applications

Biomimetic bone regeneration

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