Difference in the fusion rate and bone formation between artificial bone and iliac autograft inside an inter-body fusion cage – A comparison between porous hydroxyapatite/type 1 collagen composite and autologous iliac bone

Kushioka, Junichi; Kaito, Takashi; Makino, Takahiro; Fujiwara, Hiroyasu; Tsukazaki, Hiroyuki; Takenaka, Shota; Sakai, Yusuke; Yoshikawa, Hideki

doi:10.1016/j.jos.2018.03.006

Cited by 12 publications

(13 citation statements)

References 31 publications

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“…A porous hydroxyapatite/collagen (HAp/Col) composite (ReFit; HOYA Technosurgical, Tokyo, Japan), composed of nano-scale HAp and porcine type 1 collagen, is a recently developed material for bone substitute [11,12]. The sponge-like elasticity of HAp/Col is an important characteristic of this graft material because it fits in the space of the bone matrix without any gap, allowing bone formation to extend continuously from the matrix bone [11,13].…”

Section: Introductionmentioning

confidence: 99%

“…The sponge-like elasticity of HAp/Col is an important characteristic of this graft material because it fits in the space of the bone matrix without any gap, allowing bone formation to extend continuously from the matrix bone [11,13]. Good bio-resorbability, high osteoconductivity, and bone regeneration ability were shown when used to treat defects in the long bones in animal models and in clinical trials [11,12,14,15]. However, the efficacy of the repair of iliac bone defect with HAp/Col composite was unknown.…”

Section: Introductionmentioning

confidence: 99%

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Repair of Iliac Crest Defects with a Hydroxyapatite/Collagen Composite

et al. 2020

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This study aimed to assess the effect of refilling with hydroxyapatite/collagen (HAp/Col) composite on an iliac crest defect after spinal fusion. Overview of Literature: The use of iliac crest bone graft has been the gold standard in spinal fusion for a long time because of its biological and non-immunologic properties. Few reports have addressed how bone defects recover after iliac crest bone harvest following spinal fusion. Methods: Cancellous bone was collected from the anterior iliac crest during lateral interbody fusion (LIF), and the bone void of the ilium was refilled with a porous HAp/Col composite. We assessed bone recovery using computed tomography (CT). From the 74 patients who underwent LIF between January 2015 and December 2016, we included 49 patients whose iliac crest could be evaluated using CT at 3 months and 1 year after the surgery. Results: Bone defects decreased in a time-dependent manner after the surgery. Cortical closure was observed in 28.5% of the cases 3 months after the surgery; at 1 year postoperatively, 95.9% of the patients had cortical closure. Complete repair of the cancellous bone was achieved in 57.1% of the patients at 3 months after the surgery and in 95.9% at 1 year after the surgery. There were no significant hematomas, infections, iliac crest fractures, or soft tissue herniation. Conclusions: Radiographic recovery of cortical and cancellous bone defects was achieved with high probability via refilling with HAp/Col composite over the 1-year period.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Repair of Iliac Crest Defects with a Hydroxyapatite/Collagen Composite

et al. 2020

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“…As described previously, HAp/Col composite has a sponge-like mechanical property; thus, it is very easily integrated with BMA and packed inside the titanium cage. A previous study also examined this material in the lumbar lateral interbody fusion cage and proved the clinical usefulness of the HAp/Col composite [ 25 ]. In this study, we applied the HAp/Col composite in 50 patients and it showed excellent bioavailability; no significant adverse events regarding the HAp/Col composite were observed.…”

Section: Discussionmentioning

confidence: 99%

Hydroxyapatite/collagen composite graft for posterior lumbar interbody fusion: a comparison with local bone graft

et al. 2021

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Background Autologous bone has been used for posterior lumbar intervertebral fusion (PLIF). However, harvesting autologous bone graft is associated with donor site complications. We previously developed a hydroxyapatite/collagen (HAp/Col) composite as an osteoconductive artificial bone, characterized by having a highly porous structure with sponge‐like elasticity. This study aims to investigate the effectiveness of HAp/Col composite with bone marrow aspirate (BMA) as a graft substitute in PLIF for the treatment of lumbar spinal diseases. Methods This study prospectively investigated patients who received one-level PLIF. For the interbody fusion, two titanium cages were inserted. On the one side of interbody space, HAp/Col composite incorporated with BMA filling the titanium cage was grafted. On the other side, local bone graft (LBG) harvested during decompressive laminotomy was grafted and then one-level instrumentation using pedicle screws was performed. The target levels were at L2/3 in 2 cases, L3/4 in 3 cases, L4/5 in 36 cases, and L5/S in 5 cases. We evaluated clinical symptoms and radiological outcomes of 46 patients and compared the fusion status of HAp/Col composite with that of LBG. Results The 1-year postoperative CT evaluation demonstrated that, in the HAp/Col, a complete fusion was observed in 38 patients (82.6%), whereas in the LBG, a complete fusion was observed in 35 patients (76.1%). There were no statistical differences between the HAp/Col and LBG. In the HAp/Col, incomplete fusion was observed in five patients (10.9%) and non-fusion in two patients (4.3%), and in the LBG, incomplete fusion was observed in nine patients (19.6%) and non-fusion in two patients (4.3%). At 2 years after the surgery, complete fusion increased to 44 patients (95.7%) in the HAp/Col and 41 patients (89.1%) in the LBG. There were no significant differences in the clinical scores for lumbar spine between patients with fusion and non-fusion. Conclusions The HAp/Col composite with BMA in the titanium cage can be effectively used as an alternative to conventional autologous LBG for intervertebral spinal fusion. Trial registration University hospital Medical Information Network, UMIN000045010, July 30th, 2021, Retrospectively registered, https://www.umin.ac.jp/english/.

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“…On the other hand, osteoinductivity is rarer and could be described as the most sought‐after property of bone substitutes. Autologous bone has long been the superior (gold standard) bone substitute in human and animal studies 6–8 . This is due to their unmatched osteoinductive, osteoconductive, and osteogenic nature.…”

Section: Classificationmentioning

confidence: 99%

A novel classification of bone graft materials

2022

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Over the past few decades, the field of biomaterials concerning bone tissue engineering has gained a significant amount of interest. This has led to new biomaterials to be used as bone substitute materials. Despite the rapid increase in the types and forms of bone substitutes, a comprehensive classification encompassing all types of bone graft materials that have so far been developed and evaluated is lacking. Therefore, this review aims to integrate and bring together the published data on bone substitutes within the last 5 years and produce a novel classification that would provide bone material researchers with a better understanding of what materials have so far been used and evaluated and the areas, where research is lacking and deserves more attention. The literature available in all major databases was obtained and filtered using an elimination criterion to extract all the articles related to studies that tested bone substitute materials in nonclinical and clinical trials over the last 5 years. The review article would provide bone material researchers with an insight into the materials that have been evaluated for bone tissue engineering applications and identify future perspectives for bone graft material research.

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Difference in the fusion rate and bone formation between artificial bone and iliac autograft inside an inter-body fusion cage – A comparison between porous hydroxyapatite/type 1 collagen composite and autologous iliac bone

Cited by 12 publications

References 31 publications

Repair of Iliac Crest Defects with a Hydroxyapatite/Collagen Composite

Repair of Iliac Crest Defects with a Hydroxyapatite/Collagen Composite

Hydroxyapatite/collagen composite graft for posterior lumbar interbody fusion: a comparison with local bone graft

A novel classification of bone graft materials

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