The Reinforcement of Cancellous Bone Screws with Calcium Phosphate Cement

Mermelstein, Laurence E.; Chow, Laurence C.; Friedman, Craig D.; Crisco, Joseph J.

doi:10.1097/00005131-199601000-00003

Cited by 41 publications

(26 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Besides, other successful attempts have been made to use these formulations for calcaneal fractures [509], hip fractures [510,511], augmentation of osteoporotic vertebral bodies [512], distal radius fractures [513], tibial plateau fractures [33,[513][514][515][516][517], restoration of pedicle screw fixation [518,519], reinforcement of thoracolumbar burst fractures [520], cancellous bone screws [521,522], in wrist arthrodesis [523] and for fixation of titanium implants [524]. A recent study on a cement augmentation of the femoral neck defect might be found elsewhere [525].…”

Section: Orthopaedic Applicationsmentioning

confidence: 99%

Self-Setting Calcium Orthophosphate Formulations: Cements, Concretes, Pastes and Putties

Dorozhkin¹

2012

IJMC

View full text Add to dashboard Cite

In early 1980s, researchers discovered self-setting calcium orthophosphate cements, which are a bioactive and biodegradable grafting material in the form of a powder and a liquid. Both phases after mixing form a viscous paste that after being implanted sets and hardens within the body as either a non-stoichiometric calcium deficient hydroxyapatite (CDHA) or brushite, sometimes blended with un-reacted particles and other phases. As both CDHA and brushite are remarkably biocompartible and bioresorbable (therefore, in vivo they can be replaced with a newly forming bone), self-setting calcium orthophosphate cements represent a good correction technique of non-weight-bearing bone fractures or defects and appear to be very promising materials for bone grafting applications. Besides, these cements possess an excellent osteoconductivity, molding capabilities, and easy manipulation. Nearly perfect adaptation to the tissue surfaces in bone defects and a gradual bioresorption followed by new bone formation are additional distinctive advantages of calcium orthophosphate cements. Besides, reinforced formulations are available; those are described as calcium orthophosphate concretes. Furthermore, formulations with high viscosity, such as pastes and putties are also known. The discovery of self-setting formulations has opened up a new era in the medical application of calcium orthophosphates; several commercial compositions have already been introduced as a result. Many more formulations are in experimental stages. In this review, an insight into the self-setting calcium orthophosphate formulations, as excellent biomaterials suitable for both dental and bone grafting applications, has been provided.

show abstract

Section: Orthopaedic Applicationsmentioning

confidence: 99%

Self-Setting Calcium Orthophosphate Formulations: Cements, Concretes, Pastes and Putties

Dorozhkin¹

2012

IJMC

View full text Add to dashboard Cite

show abstract

“…However, the use of CPC in low-quality cancellous bone to enhance screw purchase is less well described although the technique has proven to significantly reduce the frequency of complications such as loosening and migration (Mermelstein et al, 1996;Andreassen et al, 2004). In hip fractures, small amounts of CPC have been shown to enhance conventional hip fracture screw purchase and to increase the fracture construct stiffness and minimize hip fracture screw displacement (Stankewich et al, 1996;Elder et al, 2000;von der Linden et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Injectable calcium phosphate cement for augmentation around cancellous bone screws. In vivo biomechanical studies

Larsson

Stadelmann

Arnoldi

et al. 2012

Journal of Biomechanics

View full text Add to dashboard Cite

a b s t r a c tIn lower cancellous apparent bone density, it can be difficult to achieve adequate screw fixation and hence stable fracture fixation. Different strategies have been proposed, one of them is through augmentation using calcium phosphate cement in the region at or close to the screw thread itself. To support the hypothesis of an improved screw fixation technique by augmentation of the bone surrounding the implanted screw, in vivo biomechanical and densitometric studies are performed on rabbit specimen where normal and simulated weak bone quality are considered. In particular, the evolution of screw stability till 12 weeks following the implantation is quantified. A statistical significance in the pull out force for augmented versus non-augmented screws was found for the shorter time periods tested of r 5 days whilst the pull out force was found to increase with time for both augmented and non-augmented screws during the 12 week course of the study. The results of the study demonstrate that the use of an injectable calcium phosphate cement which sets in vivo can significantly improve screw pull out strength at and after implantation for normal and simulated weak bone quality.

show abstract

“…[12][13][14][18][19][20] Only a few studies have been done in vivo. 21 In this study, we augmented cancellous screw fixation in vivo using rabbits older than 1 year, in which the growth plates had already closed.…”

Section: Discussionmentioning

confidence: 99%

“…22,23 Some authors showed that CPC was also useful for augmenting screw fixation. [18][19][20] CPC is an injectable, nonexothermic cement. CPC is slowly resorbed and replaced with living bone, 24 but the mechanical strength of CPC is inferior to that of PMMA.…”

Section: Discussionmentioning

confidence: 99%

Augmentation of cancellous screw fixation with hydroxyapatite composite resin (CAP)in vivo

Kawagoe

Saito

Shibuya³

et al. 2000

J. Biomed. Mater. Res.

View full text Add to dashboard Cite

The fixation of fractured bone with screws is important for orthopedic surgery, however, rigid fixation often cannot be attained in elderly patients with osteoporosis. Recently, we developed a new injectable, nonresorbable bone cement (CAP) that possesses mechanical and biological properties superior to those of polymethylmethacrylate (PMMA) cement. CAP can directly bond with bone without intervening fibrous tissue, and the peak curing temperature is 46 degrees C. In this study, we assessed the effects of CAP and PMMA cement on the augmentation of screw fixation in vivo. A cancellous screw was placed in the proximal metaphysis of rabbit tibiae. One side of each tibia was randomly selected to be augmented with CAP or PMMA. The contralateral side received a screw without cement (control). Of the 36 rabbits included in this study, 9 rabbits from each group were sacrificed and the tibial constructs retrieved 1 or 3 months after the initial operation. The screws were then pulled out to failure. The values of the pullout force of the screws augmented with CAP and PMMA were higher than those of the control specimens at both 1 month (319 +/- 58 N for CAP vs. 105 +/- 41 N for control; p < 0.05, 284 +/- 100 N for PMMA vs. 132 +/- 71 N for control; p < 0.05) and 3 months (387 +/- 109 N for CAP vs. 196 +/- 107 N for control; p < 0.05, 372 +/- 145 N for PMMA vs. 242 +/- 100 N for control; p > 0.05) after the operation. However, the average increase in the pullout force between CAP and PMMA augmentation was not statistically significant at either time. The values of energy absorption augmented with CAP and PMMA were also higher than those of the control specimens at both 1 month (129 +/- 54 N*mm for CAP vs. 19 +/- 10 N*mm for control; p < 0.05, 145 +/- 95 N*mm for PMMA vs. 28 +/- 21 N*mm for control; p < 0.05) and 3 months (172 +/- 58 N*mm for CAP vs. 44 +/- 41N*mm for control; p < 0.05, 185 +/- 198 N*mm for PMMA vs. 67 +/- 49N*mm for control; p > 0.05) after the operation. However, there were also no significant differences in energy absorption between the two types of cement augmentation. On the other hand, a significant increase was not observed in stiffness among the CAP, PMMA, and respective control groups at either 1 month (626 +/- 133 N/mm for CAP vs. 441 +/- 180 N/mm for control; p < 0.05, 577 +/- 87 N/mm for PMMA vs. 450 +/- 121 N/mm for control; p > 0.05) or 3 months (622 +/- 144 N/mm for CAP vs. 600 +/- 204 N/mm for control; p > 0.05, 633 +/- 175 N/mm for PMMA vs. 630 +/- 168 N/mm for control; p > 0.05) after the operation, except in the average increase between CAP augmentation and its control 1 month after the operation. These results suggested that a cancellous screw fixation augmented with CAP, as well as PMMA, was effective compared with the unaugmented control in vivo. Because of its biocompatibility and low curing temperature, CAP can be used clinically to augment cancellous screw fixation.

show abstract

The Reinforcement of Cancellous Bone Screws with Calcium Phosphate Cement

Cited by 41 publications

References 32 publications

Self-Setting Calcium Orthophosphate Formulations: Cements, Concretes, Pastes and Putties

Self-Setting Calcium Orthophosphate Formulations: Cements, Concretes, Pastes and Putties

Injectable calcium phosphate cement for augmentation around cancellous bone screws. In vivo biomechanical studies

Augmentation of cancellous screw fixation with hydroxyapatite composite resin (CAP)in vivo

Contact Info

Product

Resources

About