Biomechanical Evaluation of Promising Different Bone Substitutes in a Clinically Relevant Test Set-Up
Biomechanical Evaluation of Promising Different Bone Substitutes in a Clinically Relevant Test Set-Up
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DOI：
10.3390/ma12091364
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发表时间：
2019-05-01
期刊：
影响因子：
3.4
通讯作者：
Hoelscher-Doht, Stefanie
中科院分区：
文献类型：
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作者：
Brueckner, Theresa;Heilig, Philipp;Hoelscher-Doht, Stefanie
(1)背景：骨替代物在骨科手术中用于填充大面积骨缺损是必不可少的。因此，本研究的目的是在临床相关试验装置中比较不同骨填充物的生物力学，并检测临床使用中稳定性和操作的差异。(2)研究方法：本研究结合了抗压强度测试和螺钉拔出测试以及在临床相关生物力学骨折模型中骨替代物的动态测试。除了成熟的骨填充物（ChronOS（TM）Inject和Graftys（R）Quickset）外，还研究了两种新设计的骨替代物，磷酸镁骨水泥（MPC）和可钻孔水凝胶增强磷酸钙骨水泥（CPC）。(3)结果如下：在临床相关生物力学模型中，可钻孔CPC显示骨折位移和最大载荷与其商业对应物（Graftys（（R））Quickset）相当，即使使用Graftys（（R））的抗压强度和螺钉拔出力更高。(4)结论：内部制备的骨水泥在补充后允许无问题钻孔，对稳定性无负面影响。MPC是一种新的、有前途的骨替代材料，在纯材料测试（最高抗压强度和螺钉拔出力）以及临床相关骨折模型（最低位移和最高最大载荷）中，它显示出所有四种骨水泥类型的最佳总体结果。低粘度使得能够非常有效地与松质骨交错并完全填充缺损，从而证明具有高稳定性。总之，这两种内部开发的骨填充物显示出总体良好的结果，并正在为临床应用开辟新的发展方向。
(1) Background: Bone substitutes are essential in orthopaedic surgery to fill up large bone defects. Thus, the aim of the study was to compare diverse bone fillers biomechanically to each other in a clinical-relevant test set-up and to detect differences in stability and handling for clinical use. (2) Methods: This study combined compressive strength tests and screw pullout-tests with dynamic tests of bone substitutes in a clinical-relevant biomechanical fracture model. Beyond well-established bone fillers (ChronOS(TM) Inject and Graftys((R)) Quickset), two newly designed bone substitutes, a magnesium phosphate cement (MPC) and a drillable hydrogel reinforced calcium phosphate cement (CPC), were investigated. (3) Results: The drillable CPC revealed a comparable displacement of the fracture and maximum load to its commercial counterpart (Graftys((R)) Quickset) in the clinically relevant biomechanical model, even though compressive strength and screw pullout force were higher using Graftys((R)). (4) Conclusions: The in-house-prepared cement allowed unproblematic drilling after replenishment without a negative influence on the stability. A new, promising bone substitute is the MPC, which showed the best overall results of all four cement types in the pure material tests (highest compressive strength and screw pullout force) as well as in the clinically relevant fracture model (lowest displacement and highest maximum load). The low viscosity enabled a very effective interdigitation to the spongiosa and a complete filling up of the defect, resulting in this demonstrated high stability. In conclusion, the two in-house-developed bone fillers revealed overall good results and are budding new developments for clinical use.