Bone has great self-healing
capacity, but above a certain critical
size, bone defects will not heal spontaneously, requiring intervention
to achieve full healing. Among the synthetic calcium phosphate (CaP)
bone replacement materials, brushite (CaHPO4·2H2O)-based materials are of particular interest because of their
degree of solubility and the related high potential to promote bone
regeneration after dissolution. They can be produced tailor-made using
modern three-dimensional (3D) printing technology. Although this type
of implant has been widely tested in vitro, there are only limited
in vivo data and less so in a relevant large animal model. In this
study, material properties of a 3D-printed brushite-based scaffold
are characterized, after which the material is tested by in vivo orthotopic
implantation in the equine tuber coxae for 6 months. The implantation
procedure was easy to perform and was well tolerated by the animals,
which showed no detectable signs of discomfort. In vitro tests showed
that compressive strength along the vertical axis of densely printed
material was around 13 MPa, which was reduced to approximately 8 MPa
in the cylindrical porous implant. In vivo, approximately 40% of the
visible volume of the implants was degraded after 6 months and replaced
by bone, showing the capacity to stimulate new bone formation. Histologically,
ample bone ingrowth was observed. In contrast, empty defects were
filled with fibrous tissue only, confirming the material’s
osteoconductive capacity. It is concluded that this study provides
proof that the 3D-printed brushite implants were able to promote new
bone growth after 6 months’ implantation in a large animal
model and that the new equine tuber coxae bone model that was used
is a promising tool for bone regeneration studies.