Mechanical behaviour of Bioactive Glass granules and morselized cancellous bone allograft in load bearing defects

Hulsen, D.J.W.; Geurts, Jan; Gestel, van Nap Nicole; Rietbergen, van B Bert; Arts, Jacobus J.

doi:10.1016/j.jbiomech.2016.02.047

Cited by 11 publications

(21 citation statements)

References 51 publications

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“…Before confined compression tests were performed, the samples were impacted using a custommade impaction device, to obtain clinically relevant impaction strains, as previously described (Hulsen et al 2016;Walschot et al 2010). The height of each sample was measured prior to impaction, represented as ℎ !…”

Section: Sample Preparationmentioning

confidence: 99%

“…After impaction all samples were subjected to dynamic confined compression tests using a biomaterials testing system (858 Mini Bionix®, MTS Systems Corporation, Eden Prairie, MN, USA). The loading regime consisted of two dynamic loading phases and two resting phases and was based on the loading regime as previously described (Hulsen et al 2016;Walschot et al 2010). Briefly, during the dynamic loading phases the samples were subjected to 900 sinusoidal loading cycles (40-850 N at 1 Hz) followed by 300 seconds of rest (unloaded).…”

Section: Confined Compression Testsmentioning

confidence: 99%

“…Osteomyelitis commonly occurs in long bones and therefore not only the antibacterial and bone bonding properties are of importance, but also the load-bearing capacity of the material, especially if the treated defect is located in the lower extremities. From earlier studies, it is known that bioactive glass granules can withstand considerable compressive loading in confined conditions, while the bioactive glass graft layer can be similar to that of cancellous bone (Hulsen et al 2016).…”

Section: Introductionmentioning

confidence: 99%

“…These putty formulations provide a composite material that is both formable and injectable. While the composition of the bioactive glass granules in the putty was not changed, the mixture of different granule sizes and the addition of the binder could considerably change the mechanical properties of the graft layer compared to those measured for the granules alone (Hulsen et al 2016;Iviglia et al 2016). The aim of this study was therefore to determine the composition dependent impaction, creep, and residual strains and aggregate modulus in confined compression.…”

Section: Introductionmentioning

confidence: 99%

“…These parameters could provide knowledge of the graft material for the possible application in load-bearing bone defect grafting, in which graft layer stability is highly important. Dynamic confined compression tests were performed similar to those used in earlier studies on bone graft substitute materials (Walschot et al 2010;Hulsen et al 2016). To study the relation between the formulation of the putty and the mechanical properties, the composition of the putty was varied in synthetic binder and glass granule content.…”

Section: Introductionmentioning

confidence: 99%

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Composition dependent mechanical behaviour of S53P4 bioactive glass putty for bone defect grafting

Gestel

Hulsen

Geurts

et al. 2017

Journal of the Mechanical Behavior of Biomedical Materials

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To improve the handling properties of S53P4 bioactive glass granules for clinical applications, bioactive glass putty formulations were developed. These formulations contain both granules and a synthetic binder to form an injectable material that is easy to shape. To explore its applicability in load-bearing bone defect grafting, the relation between the putty composition and its mechanical behaviour was assessed in this study. Five putty formulations with variations in synthetic binder and granule content were mechanically tested in confined compression. The results showed that the impaction strains significantly decreased and the residual strains significantly increased with an increasing binder content. The stiffness of all tested formulations was found to be in the same range as the reported stiffness of cancellous bone. The measured creep strains were low and no significant differences between formulations were observed. The stiffness significantly increased when the samples were subjected to a second loading stage. The residual strains calculated from this second loading stage were also significantly different from the first loading stage, showing an increasing difference with an increasing binder content. Since residual strains are detrimental for graft layer stability in load-bearing defects, putty compositions with a low binder content would be most beneficial for confined, load-bearing bone defect grafting.

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Section: Sample Preparationmentioning

confidence: 99%

Section: Confined Compression Testsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Composition dependent mechanical behaviour of S53P4 bioactive glass putty for bone defect grafting

Gestel

Hulsen

Geurts

et al. 2017

Journal of the Mechanical Behavior of Biomedical Materials

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Bioactive glass as dead space management following debridement of type 3 chronic osteomyelitis

Oosthuysen

Venter

Tanwar

et al. 2019

International Orthopaedics (SICOT)

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Background Chronic osteomyelitis is a challenging condition to treat and although no exact treatment guidelines exist, the surgical management strategy includes wide resection of necrotic and infected bone followed by dead space management. This study evaluates the use of bioactive glass as a single-stage procedure for dead space management following surgical debridement. Methods A consecutive series of 24 patients with Cierny-Mader type 3 osteomyelitis, treated between March 2016 and June 2018, were identified and evaluated retrospectively. Patients were managed with bioactive glass as dead space management following surgical debridement. Results Of the patients who completed more than 12 months follow-up, all fourteen (100%) showed complete resolution of symptoms. Of the remaining ten patients with less than 12 months follow-up, eight had complete resolution of symptoms. Therefore, a preliminary result of 22 out of 24 patients (91.65%) had resolution of symptoms following debridement and dead space management with bioactive glass. One patient experienced a complication related to the use of bioactive glass. This manifested as prolonged serous wound drainage that resolved with local wound care. Conclusion The use of bioactive glass appears to be effective for dead space management following debridement of anatomical type 3 chronic osteomyelitis of the appendicular skeleton.

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Resorption of the calcium phosphate layer on S53P4 bioactive glass by osteoclasts

Gestel

Schuiringa

Hennissen

et al. 2019

J Mater Sci: Mater Med

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Clinically, S53P4 bioactive glass (BAG) has shown very promising results in bone infection treatment, but it is also known to degrade very slowly in vivo. To evaluate which mechanisms (cellular or dissolution) can play a role in the degradation of S53P4 BAG and S53P4 BAG putty, in vitro degradation experiments at different pH (7.4 and 4.6) were performed. Micro computed tomography showed a rapid dissolution of the synthetic binder in the putty formulation, within 12 h is simulated body fluid (pH = 7.4), leaving behind only loose granules. Therefore the degradation of the loose granules was investigated further. Significant weight loss was observed and ion chromatography showed that Ca 2+ , Na + and PO 4 3− ions were released from S54P4 BAG granules in the two fluids. It was observed that the weight loss and ion release were increased when the pH of the fluid was decreased to 4.6. Osteoclasts are known to create such a low pH when resorbing bone and therefore their capacity to degrade S53P4 surfaces were studied as well. Scanning electron microscopy and energy-dispersive X-ray spectroscopy confirmed that osteoclasts were able to create resorption pits in the calcium phosphate layer on S53P4 BAG surfaces. The silica of the BAG, located underneath the calcium phosphate, seemed to hinder further osteclastic resorption of the material. To our knowledge we were the first to observe actively resorbing osteoclasts on S53P4 bioactive glass surfaces, in vitro. Future research is needed to define the specific role osteoclasts play in the degradation of BAG in vivo.

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Mechanical behaviour of Bioactive Glass granules and morselized cancellous bone allograft in load bearing defects

Cited by 11 publications

References 51 publications

Composition dependent mechanical behaviour of S53P4 bioactive glass putty for bone defect grafting

Composition dependent mechanical behaviour of S53P4 bioactive glass putty for bone defect grafting

Bioactive glass as dead space management following debridement of type 3 chronic osteomyelitis

Resorption of the calcium phosphate layer on S53P4 bioactive glass by osteoclasts

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