Região metafisária da tíbia de coelhos: uma opção para estudos dos substitutos ósseos / Metaphyseal region of the tibia of rabbits: an option for bone substitutes studies

Apresenta-se um modelo experimental de ostectomia de tíbia em coelhos para estudo de biomateriais em processos de reparação óssea. Foi realizada falha segmentar de 6mm de diâmetro na região metafisária medial proximal de tíbia de 72 coelhos as quais foram preenchidas com substituto ósseo e avaliadas clinicamente, por exame radiográfico e por meio de tomografia computadorizada feixe cônico, em diferentes tempos. Conclui-se que a metáfise medial proximal de tíbia de coelhos é adequada como modelo para estudos que avaliem o comportamento de enxertos e/ou biomateriais em falhas ósseas.

Is presented an experimental model of tibial ostectomy in rabbits to study biomaterials during bone repair process. Segmental failure of 6 mm diameter was performed in the medial proximal tibial metaphyseal region of 72 rabbits, which were filled with bone substitute and evaluated by clinical exam, X-ray, and cone beam computed tomography at different times. It is concluded that the medial proximal tibial metaphysis region of rabbits is suitable as a model for studies that evaluate the behavior of grafts and/or biomaterials on bone defects.

Electrospun novel nanocomposite comprising polyurethane integrated with ayurveda amla oil for bone tissue engineering.

Ayurveda oil contains numerous source of biological constituents which plays an important role in reducing the pain relief caused during bone fracture. The aim of the study is to fabricate the polyurethane (PU) scaffold for bone tissue engineering added with ayurveda amla oil using electrospinning technique. Scanning Electron Microscopy (SEM) analysis showed that the fabricated nanocomposites showed reduced fiber diameter (758 ± 185.46 nm) than the pristine PU (890 ± 116.91 nm). Fourier Infrared Analysis (FTIR) revealed the existence of amla oil in the PU matrix by hydrogen bond formation. The contact angle results revealed the decreased wettability (116° ± 1.528) of the prepared nanocomposites compared to the pure PU (100° ± 0.5774). The incorporation of amla oil into the PU matrix improved the surface roughness. Further, the coagulation assay indicated that the addition of amla oil into PU delayed the blood clotting times and exhibited less toxic to red blood cells. Hence, the fabricated nanocomposites showed enhanced physicochemical and better blood compatibility parameters which may serve as a potential candidate for bone tissue engineering.

Analysis of Bone Mineral Profile After Prolonged Every-Other-Day Feeding in C57BL/6J Male and Female Mice.

Intermitted fasting or every-other-day feeding (EOD) has many positive effects in rodents and humans. Our goal was to describe how EOD influences bone mineral composition in female and male mice under prolonged EOD feeding. Male and female adult mice were fed EOD for 9 months. After this time, we used a direct method of measurement of mineral components in ashes of long bones (humerus and radius) to estimate the content of calcium (Ca), phosphorus (P), potassium (K), magnesium (Mg), and sodium (Na). We also performed histological analysis of sections of long bones. We found no significant changes in mineral composition between ad libitum and EOD fed males and females. We noted higher Ca and P contents in control males vs. females and lower content of Mg in control males vs. females. We observed the presence of marrow adipose tissue (MAT) in sections of EOD-fed females. EOD without supplementation during feeding days did not increase loss of mineral content of bones in C57BL/6J mice, but the presence of MAT only in EOD females indicates a gender-dependent response to EOD treatment in C57BL/6J mice.

Giant cells and osteoclasts present in bone grafted with nacre differ by nuclear cytometry evaluated by texture analysis.

Nacre (mother of pearl) is a natural biomaterial used to prepare orthopedic devices. We have implanted screws and plates made with nacre in five sheeps. Bone were harvested after two months and embedded in poly(methyl methacrylate). Blocks were saws and the thick slabs were grinded, polished and surface stained. Sections were photographed at an ×1000 magnification. Giant cells were found in contact with nacre in eroded areas and true osteoclasts were found at distance in the neighboring bone in Howship lacunae. A texture analysis of the nuclei of giant cells and osteoclasts was done using the run-length method of the MaZda freeware. The size of the nuclei was reduced in osteoclast and their mean gray level appeared reduced. Texture analysis revealed that chromatin had a completely different pattern in giant cells when compared to osteoclasts. Giant cells had a fine repartition of the chromatin with large clear areas around prominent nucleoli. On the contrary, osteoclast nuclei had chromatin blocks evenly dispersed in the nuclei. This reflects the different origin of these cells expressing different functions.

BONEFILL ® block as alternative for bone substitute: a toxicological evaluation

ABSTRACT Bone substitutes based on hydroxyapatite (HA) and Bonefill® (BO - inorganic bovine bone) associated with poly(lactic-co-glycolic acid) (PLGA) (HA/PLGA and BO/PLGA) were evaluated concerning cytotoxicity, genotoxicity and mutagenicity as potential candidates for bone repair. The materials were developed and provided by Bionnovation Biomedical Products Ltda. Eluates from these bone substitutes were prepared for toxicity evaluations using eukaryotic cell cultures. HA/PLGA was used as a comparison for Bonefill®. Cell viability was evaluated by XTT assay and surviving fraction was calculated for clonogenic survival. Additionally, tail moment was used to assess genotoxicity (comet assay). The frequencies of binucleated cells with micronucleus (FBMN), micronucleus (FMN), nucleoplasmic bridges (NPBs), and nuclear buds (NBUDs) were analysed by cytokinesis-block micronucleus assay (CBMN assay). Results showed no statistical difference in cell viability compared with negative control (NC) The eluates did not promote delayed cytotoxicity whereas the surviving fraction rate for cultured cells was similar to NC. Furthermore, no genotoxicity or mutagenicity effects were observed for cultured cells with the Bonefill/PLGA and HA/PLGA eluates. In conclusion, the negative cytotoxicity, genotoxicity and mutagenicity results indicate that these bone substitutes presented interesting preliminary results as potential biomaterials for bone repair.

Aspecto morfológico da interface entre o compósito, constituído de quitosana e polimetilmetacrilato, e a falha óssea de tíbia de coelhos / Morphological aspect of the interface between the composite, made of chitosan and polymethylmethacrylate, and bone failure of the rabbit tibia

As afecções ortopédicas com perda de tecido ósseo são um desafio não só na medicina veterinária mas também na medicina humana. Analisou a interface entre compósito, constituído de esferas de quitosana e polimetilmetacrilato em falha óssea (leito receptor) de tíbia de coelhos, por meio de técnica radiológica, avaliação macroscópica e pela microscopia eletrônica de varredura, em diferentes tempos. Foram utilizados 12 coelhos adultos da raça Nova Zelândia, divididos em quatro Grupos Experimentais (E1, n=3; E2, n=3; E3, n=3 e E4, n=3), que tiveram as falhas ósseas das tibiais direitas preenchidas com compósito, e avaliadas no pós-operatório imediato, aos 30, 60 e 90 e 120 dias. Dos compósitos implantados nas tíbias de coelhos, apenas dois permaneceram em seus leitos receptores, enquanto que os demais se encontravam encapsulados no tecido subcutâneo. As esferas de quitosana, presentes nas superfícies dos biomateriais implantados, que mantiveram contato direto com o leito receptor de tíbias de coelhos apresentavam-se preservadas e não integraram ao tecido ósseo. Diante disso, para melhor compreensão do comportamento da quitosana como substituto ósseo, novas pesquisas serão necessárias.(AU)

Orthopedic diseases with bone loss are challenging in both veterinary and human medicine. The aim of this investigation was to analyze and compare the reactions at the interface between the composite, made of chitosan and polymethylmethacrylate, and the bone defect (receptor site) of the rabbits tibia through radiological and microscopic techniques and by scanning electron microscopy, in different periods. Twelve adult New Zealand rabbits were divided into four experimental groups (E1, n=3; E2, n=3; E3, n=3 and E4, n=3), which had the right tibial bone defects filled with the composite, and evaluated in the immediate postoperative, 30, 60, 90 and 120 days. Composite implanted in the tibia of rabbits, only two remained in their beds receivers, while the remaining were encapsulated in the subcutaneous tissue. Spheres of chitosan present in the biomaterial that has been deployed and were in direct contact with the bone defect, were preserved, however, were not integrated into the bone tissue. Therefore, to understand the behavior of chitosan as a bone substitute, further research is needed.(AU)

The fabrication and characterization of barium titanate/akermanite nano-bio-ceramic with a suitable piezoelectric coefficient for bone defect recovery.

In recent years, due to the controllable mechanical properties and degradation rate, calcium silicates such as akermanite (Ca2MgSi2O7) with Ca-Mg and Si- containing bio-ceramics have received much more attention. In addition, the piezoelectric effect plays an important role in bone growth, remodeling and defect healing. To achieve our objective, the porous bioactive nano-composite with a suitable piezoelectric coefficient was fabricated by the freeze-casting technique from the barium titanate and nano-akermanite (BT/nAK) suspension. The highest d33of 4pC/N was obtained for BT90/nAK10. The compressive strength and porosity were for BT75/nAK25 and BT60/nAK40 at the highest level, respectively. The average pore channel diameter was 41 for BT75/nAK25. Interestingly enough, the inter-connected pore channel was observed in the SEM images. There was no detectable transformation phase in the XRD pattern for the BT/nAK composites. The manipulation flexibility of this method indicated the potential for the customized needs in the application of bone substitutes. An ((3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide)) MTT assay indicated that the obtained scaffolds have no cytotoxic effects on the human bone marrow mesenchymal stem cells.

Diametral compression behavior of biomedical titanium scaffolds with open, interconnected pores prepared with the space holder method.

Scaffolds with open, interconnected pores and appropriate mechanical properties are required to provide mechanical support and to guide the formation and development of new tissue in bone tissue engineering. Since the mechanical properties of the scaffold tend to decrease with increasing porosity, a balance must be sought in order to meet these two conflicting requirements. In this research, open, interconnected pores and mechanical properties of biomedical titanium scaffolds prepared by using the space holder method were characterized. Micro-computed tomography (micro-CT) and permeability analysis were carried out to quantify the porous structures and ascertain the presence of open, interconnected pores in the scaffolds fabricated. Diametral compression (DC) tests were performed to generate stress-strain diagrams that could be used to determine the elastic moduli and yield strengths of the scaffolds. Deformation and failure mechanisms involved in the DC tests of the titanium scaffolds were examined. The results of micro-CT and permeability analyses confirmed the presence of open, interconnected pores in the titanium scaffolds with porosity over a range of 31-61%. Among these scaffolds, a maximum specific surface area could be achieved in the scaffold with a total porosity of 5-55%. DC tests showed that the titanium scaffolds with elastic moduli and yield strengths of 0.64-3.47GPa and 28.67-80MPa, respectively, could be achieved. By comprehensive consideration of specific surface area, permeability and mechanical properties, the titanium scaffolds with porosities in a range of 50-55% were recommended to be used in cancellous bone tissue engineering.

Mechanical, tribological and biological properties of novel 45S5 Bioglass® composites reinforced with in situ reduced graphene oxide.

45S5 Bioglass® (45S5) is one of the most widely used biomaterials in ceramic-based bone graft substitutes by virtue of its excellent biocompatibility and bioactivity. However, the fracture toughness and wear resistance of 45S5 have to be improved to extend its applications in load bearing orthopedic implants. The current study reports the first use of graphene nanoplatelet (GNP) to enhance the fracture toughness and wear resistance of 45S5. Composite powders with four different loadings of graphene oxide (GO), i.e. 0, 0.1, 0.5 and 1wt%, were sintered by spark plasma sintering (SPS) at a relatively low temperature of 550°C, during which in situ thermal reduction of GO took place. It was found that by adding 0.5wt% GO to the 45S5 powder, the fracture toughness of the sintered pellets was increased by 130.2% while friction coefficient and specific wear rate were decreased by 21.3% and 62.0%, respectively. Furthermore, the viability of MG63 cells grown on the GNP-incorporated pellets was comparably high to that of the cells grown on the pure 45S5 pellets. As compared with the pure 45S5 leachates, the media conditioned by the GNP/45S5 pellets fabricated from the composite powder with 1wt% GO could enhance both the proliferation and viability of MG63 cells. It is thus envisioned that the GNP-reinforced 45S5 is a highly promising material for fabricating mechanically strong and biocompatible load-bearing bone implants.

Avaliação da interação biológica entre compósito de quitosana, colágeno e hidroxiapatita e tecido ósseo ovino / Investigation of biological interactions of chitosan-collagen-hydroxyapatite composite with bone tissue in sheep

As lesões em membros de grandes animais são um desafio para médicos veterinários, uma vez que somente a osteossíntese não garante resultados satisfatórios. Muitos pesquisadores vêm se dedicando ao desenvolvimento e estudo de substitutos ósseos produzidos de materiais naturais, como quitosana, colágeno e hidroxiapatita, que auxiliam na regeneração óssea. Seis ovinos fêmeas da raça Santa Inês foram submetidos a ostectomias unicorticais de sete milímetros de diâmetro na região proximal da superfície dorsomedial dos III/IV metacarpianos. Foi implantado compósito de quitosana, colágeno e hidroxiapatita em um membro torácico para avaliação da biocompatibilidade do material ao tecido ósseo ovino, e no membro contralateral foi reproduzida a mesma técnica, porém foi mantido sem preenchimento, como controle. Após 60 dias do procedimento cirúrgico, realizou-se biópsia óssea na área de interface entre biomaterial/osso (membro com compósito) e tecido neoformado/osso (membro controle), para realização de avaliação histológica do material não descalcificado, por meio de microscopia de luz e microscopia eletrônica de varredura. Na análise histomorfométrica, mediante microscopia de luz, foi possível identificar maior porcentagem de tecido neoformado em membro controle, quando comparado ao membro com compósito (80% e 63,5%, respectivamente; P<0,05). Por meio da microscopia eletrônica de varredura, observou-se invasão da estrutura interna do compósito por tecido ósseo neoformado. Não houve formação de tecido cicatricial, reação de corpo estranho ou resposta inflamatória crônica nas amostras analisadas. Conclui-se que o compósito de quitosana, colágeno e hidroxiapatita, quando implantado em tecido ósseo ovino, apresenta biocompatibilidade e perfil osteocondutor.(AU)

Fracture management poses a great challenge to large animal practitioners. Osteosynthesis alone is often insufficient to provide satisfactory outcomes in large animals; therefore, several research efforts have been made to investigate and develop bone substitutes capable of promoting bone regeneration. Chitosan-collagen-hydroxyapatite composites constitute a promising alternative given their similar composition to bone. Six Santa Inês ewes were submitted to the creation of experimental 7mm wide unicortical defects on the dorsomedial aspect of the proximal III/IV metacarpal bone diaphysis. Limbs were randomly selected for treatment with chitosan-collagen-hydroxyapatite composite or to serve as untreated controls. Biopsy fragments were collected from the bone/new bone or the bone/biomaterial interface (control and treated defects respectively) within 60 days of surgery; composite biocompatibility was assessed using light and scanning electron microscopy. Histomorphometric analysis under light microscopy revealed greater percentage of new bone tissue in control compared to treated defects (80% and 63.5% respectively; P<0.05). No scar tissue formation, foreign body or chronic inflammatory reactions were observed. Scanning electron microscopy revealed invasion of the composite by new bone tissue. The chitosan-collagen-hydroxyapatite composite studied is biocompatible with bone and shows osteoconductive properties in sheep.

Inverse liquid chromatography as a tool for characterisation of the surface layer of ceramic biomaterials.

The novel technique for ceramic biomaterials surface characterisation was proposed. The examined bone substitute materials were two orthophosphates: hydroxyapatite, ß-tricalcium phosphate and the mixture of these two - biphasic calcium phosphate. The aim of this work was characterisation of the ceramic biomaterials surface expressed via the values of parameters e, s, a, b, v considered in linear free energy relationship. The values of these parameters reflect the ability of stationary phase to occur in different types of interactions. The sorption phenomena occurring on the bone substitute materials surface are responsible for the process of the multiplication of the osteoblasts. Thus the detailed description of this phenomena may contribute to the better understanding of bone loss regeneration mechanism. The data required for characterisation by using LFER model was collected by means of inverse liquid chromatography with the use of five different mobile phases: 98% ethanol, ethanol/water (50/50), water, 0.2M NaCl and SBF. The determination of the ceramic orthophosphates surface properties in SBF solution allowed to observe the behaviour of biomaterials in "natural environment" - in living organism.

Effective atomic numbers (Zeff) of based calcium phosphate biomaterials: a comparative study.

This study determined the interaction of radiation parameters of four biomaterials as attenuators to measure the transmitted X-rays spectra, the mass attenuation coefficient and the effective atomic number by spectrometric system comprising the CdTe detector. The biomaterial BioOss® presented smaller mean energy than the other biomaterials. The µ/ρ and Zeff of the biomaterials showed their dependence on photon energy. The data obtained from analytical methods of x-ray spectra, µ/ρ and Zeff, using biomaterials as attenuators, demonstrated that these materials could be used as substitutes for dentin, enamel and bone. Further, they are determinants for the characterization of the radiation in tissues or equivalent materials.

Influence of Starting Powders on Hydroxyapatite Coatings Fabricated by Room Temperature Spraying Method.

Three types of raw materials were used for the fabrication of hydroxyapatite coatings by using the room temperature spraying method and their influence on the microstructure and in vitro characteristics were investigated. Starting hydroxyapatite powders for coatings on titanium substrate were prepared by a heat treatment at 1100 °C for 2 h of bovine bone, bone ash, and commercial hydroxyapatite powders. The phase compositions and Ca/P ratios of the three hydroxyapatite coatings were similar to those of the raw materials without decomposition or formation of a new phase. All hydroxyapatite coatings showed a honeycomb structure, but their surface microstructures revealed different features in regards to surface morphology and roughness, based on the staring materials. All coatings consisted of nano-sized grains and had dense microstructure. Inferred from in vitro experiments in pure water, all coatings have a good dissolution-resistance and biostability in water.

Variability in Particle Degradation of Four Commonly Employed Dental Bone Grafts.

BACKGROUND: Replacement bone grafting materials are used clinically for a variety of clinical procedures to augment and replace lost or missing bone. Little information is available regarding their degradation properties. PURPOSE: The aim of the present study was to investigate the degradation rate and modes of degradation of four commonly used bone grafting materials. MATERIALS AND METHODS: A natural bone mineral (NBM) of bovine origin, NBM in combination with enamel matrix derivative (EMD), LifeNet demineralized freeze-dried bone allograft (DFDBA), and Osteotech DFDBA were analyzed for particle degradation over time in 3 mm femur defects created in female Wistar rats. At 2, 4, and 8 weeks postimplantation, femur defects were assigned to histological analysis. Hematoxylin and eosin, Safranin O, tartrate-resistant acid phosphatase (TRAP), receptor activator of nuclear factor kappa B ligand (RANKL), and matrix metalloproteinase-2 (MMP-2) staining were performed to determine the rate of particle degradation, number of osteoclasts around particles, and intensity and localization of TRAP, RANKL, and MMP-2 staining. RESULTS: In the present study, NBM particles demonstrated little signs of degradation. The combination of NBM with EMD significantly increased the number of osteoclasts around NBM particles and increased expression of RANKL and MMP-2 specifically around particle surface. Only minor resorption was observed. Both DFDBA particles showed much faster degradation of particles. Interestingly, fewer osteoclasts were found on their surface when compared with NBM particles, specifically on Osteotech DFDBA particles, suggesting an alternative mode of degradation. Osteotech DFDBA particles demonstrated significantly faster degradation when compared with all other bone grafts. No obvious increase in TRAP, RANKL, or MMP2 was observed to validate this fast rate of degradation. CONCLUSIONS: The results from the present study demonstrate a wide range of particle degradation between various commonly commercially available bone grafts. Further research to determine the precise mechanisms that influence particle degradation is necessary.

Comparative studies on ectopic bone formation in porous hydroxyapatite scaffolds with complementary pore structures.

Vascularized bone grafts were constructed by implanting hydroxyapatite (HA) scaffolds with complementary macro-pore structures into the dorsal muscle of dogs. The relationship between pore structures and ectopic bone formation properties was investigated. Two types of scaffolds with complementary porous structures were fabricated by spherulite-accumulating and porogen-preparing methods, and were named spherulite HA-positive and porogen HA-negative, respectively. After implantation for 1 month, histological observation showed that all the scaffolds were encapsulated by normal muscle tissue and multiple vascular net with cells, indicating excellent biocompatibility and pore interconnectivity of the scaffolds. In the spherulite HA-positive scaffolds, a number of osteoclasts and osteoblasts coupled with new bone tissues were found after 3 and 6 months' implantations, which was better than those in the porogen HA-negative scaffolds. Similarly, the improvement of mechanical properties and the reconstruction of materials in the spherulite HA-positive scaffolds were superior to those in the porogen HA-negative scaffolds. The different ectopic bone formation induced by different macro-pore structures after intramuscular implantation demonstrated the significant effect of macro-pore structures of scaffolds on osteoinduction and vascularization.

Accurate characterization of pure silicon-substituted hydroxyapatite powders synthesized by a new precipitation route.

This paper presents a new aqueous precipitation method to prepare silicon-substituted hydroxyapatites Ca10(PO4)6-y(SiO4)y(OH)2-y(VOH)y (SiHAs) and details the characterization of powders with varying Si content up to y=1.25molmolSiHA(-1). X-ray diffraction, transmission electron microscopy, solid-state nuclear magnetic resonance and Fourier transform infrared spectroscopy were used to accurately characterize samples calcined at 400°C for 2h and 1000°C for 15h. This method allows the synthesis of monophasic SiHAs with controlled stoichiometry. The theoretical maximum limit of incorporation of Si into the hexagonal apatitic structure is y<1.5. This limit depends on the OH content in the channel, which is a function of the Si content, temperature and atmosphere of calcination. These results, particularly those from infrared spectroscopy, raise serious reservations about the phase purity of previously prepared and biologically evaluated SiHA powders, pellets and scaffolds in the literature.

The in vivo performance of CaP/PLGA composites with varied PLGA microsphere sizes and inorganic compositions.

Enrichment of calcium phosphate (CaP) bone substitutes with poly(lactic-co-glycolic acid) (PLGA) microspheres to create porosity overcomes the problem of poor CaP degradation. The degradation of CaP-PLGA composites can be customized by changing the physical and chemical properties of PLGA and/or CaP. However, the effect of the size of dense (solid rather than hollow) PLGA microspheres in CaP has not previously been described. The present study aimed at determining the effect of different dense (i.e. solid) PLGA microsphere sizes (small (S) ~20µm vs. large (L) ~130µm) and of CaP composition (CaP with either anhydrous dicalcium phosphate (DCP) or calcium sulphate dihydrate (CSD)) on CaP scaffold biodegradability and subsequent bone in-growth. To this end mandibular defects in minipigs were filled with pre-set CaP-PLGA implants, with autologous bone being used as a control. After 4weeks the autologous bone group outperformed all CaP-PLGA groups in terms of the amount of bone present at the defect site. On the other hand, at 12weeks substantial bone formation was observed for all CaP-PLGA groups (ranging from 47±25% to 62±15%), showing equal amounts of bone compared with the autologous bone group (82±9%), except for CaP with DCP and large PLGA microspheres (47±25%). It was concluded that in the current study design the difference in PLGA microsphere size and CaP composition led to similar results with respect to scaffold degradation and subsequent bone in-growth. Further, after 12weeks all CaP-PLGA composites proved to be effective for bone substitution.

Human triple cell co-culture for evaluation of bone implant materials.

Central to the formation of tissue at implant surfaces are the interactions between multiple cell types including fibroblasts, endothelial cells and, in the case of bone, cells of the osteoblastic lineage. To date the importance of population dynamics and interactions have been largely neglected in the in vitro evaluation of biomaterials. To fill this gap we have developed a co-culture system using 3 cell types, primary human bone marrow stromal cells (HBMC), microvascular endothelial cells (HMVEC) and abdominal dermal fibroblasts (HDF). Proliferation of each cell type separately and differentiation of HBMC were determined by flow cytometry analysis. The medium used promoted HBMC differentiation toward osteoblasts without affecting the state of differentiation of HDF and HMVEC. Furthermore, HBMC are strongly affected by HDF and HMVEC, and vice versa. When used on a titanium coated substrate the triple cell culture system identified preferential HBMC proliferation relative to HDF if HMVEC was present. This developed culture system represents a new, optimised and potentially predictive approach to evaluate biomaterial biocompatibility early in development.

Evaluation of collagen/heparin coated TCP/HA granules for long-term delivery of BMP-2.

Bone morphogenetic proteins (BMPs) are the most potent osteoinductive growth factors. However, a delivery system is essential to take advantage of the osteoinductive effect of BMPs. The purpose of this study was to develop a sustained delivery system for recombinant human bone morphogenetic protein-2 (BMP-2). We covalently attached heparin to a cross-linked collagen type I coated tricalciumphosphate/hydroxyapatite (TCP/HA) bone substitute and subsequently loaded it with BMP-2. To systematically evaluate the contribution of each component with respect to the binding and release of BMP-2, six constructs were prepared and characterized: TCP/HA, TCP/HA with collagen (TCP/HACol), and TCP/HA with collagen and heparin (TCP/HAColHep) with and without BMP-2 (B). More BMP-2 bound to the TCP/HAColHep + B (92.9 ± 4.8 ng BMP-2/mg granule) granules as compared to the TCP/HACol + B (69.0 ± 9.6 ng BMP-2/mg granule) and TCP/HA + B granules (62.9 ± 5.4 ng BMP-2/mg granule). No difference in release pattern was found between the TCP/HA + B and TCP/HACol + B granules. Up to day 14, BMP-2 was still bound to the TCP/HAColHep + B granules, whereas most BMP had been released from TCP/HACol + B and TCP/HA + B granules at that time. After 21 days most BMP-2 also had been released from the TCP/HAColHep + B granules. The local and sustained delivery system for BMP-2 developed in this study may be useful as a carrier for BMP-2 and could possibly enhance bone regeneration efficacy for the treatment of large bone defects.

Replicating interbody device subsidence with lumbar vertebraesurrogates.

Bone surrogates are proposed alternatives to human cadaveric vertebrae for assessing interbody device subsidence. A synthetic vertebra with representations of cortices, endplates and cancellous bone was recently developed as an alternative surrogate to polyurethane foam blocks. The ability of the two surrogates to replicate subsidence has not been fully assessed, and was evaluated by indenting them with ring-shaped indenters and comparing their performance with human cadaveric vertebrae using qualitative characteristics and indentation metrics. The sensitivity of each surrogate to a centrally or peripherally placed indenter was of particular interest. Many indentation characteristics of the foam blocks were similar to those of human cadaveric vertebrae, except their insensitivity to centrally and peripherally placed indenters, owing to their homogeneous mechanical properties. This is distinctly different from the cadaveric vertebrae, where a peripherally placed indenter indented significantly less than a centrally placed indenter, because of endplates. By contrast, the synthetic vertebra was sensitive to peripherally placed indenters owing to its bi-material composition, including a thickened peripheral endplate. However, an overly strong synthetic endplate resulted in unrepresentative indentation shape and depth. Both surrogates produced similar results to human cadaveric vertebrae in certain respects, but neither is accurate enough in terms of material property distribution to model subsidence completely in human cadaveric vertebrae.