A composite polymer/tricalcium phosphate membrane for guided bone regeneration in maxillofacial surgery.

The aim of the study was the development of a resorbable membrane for guided bone regeneration (GBR) with improved biocompatibility, which should be stiff enough to avoid membrane collapse during bone healing. Combining a bioactive ceramic with a resorbable polymer may improve the biocompatibility and osteoconductivity of resorbable devices. The present article describes the preparation, the mechanical properties, and the in vitro degradation characteristic of a composite membrane made of poly(L, DL-lactide) and alpha-tricalcium phosphate in comparison to a membrane made of pure poly(L, DL-lactide). The tensile strength and the elastic modulus as well as the molecular weight of the membranes were measured after in vitro degradation in buffer at 37 degrees C up to 28 weeks. The initial tensile strength of the composite and the polymer membrane was 37.3 +/- 2.4 MPa and 27.7 +/- 2.3 MPa and the elastic modulus 3106 +/- 108 MPa and 3101 +/- 104 MPa, respectively. The mechanical properties remained constant up to 8 weeks and then decreased slowly until week 28. The molecular weight of both membranes decreased steadily from 170,000 D to 30,000 D. It was concluded that the mechanical requirements for a membrane for GBR were fulfilled by the composite membrane.

A new bioresorbable polymer for screw augmentation in the osteosynthesis of osteoporotic cancellous bone: a biomechanical evaluation.

The aim of the study was to assess the mechanical efficacy of a new resorbable polymer developed on the basis of alkylene bis(dilactoyl)-methacrylate to improve the anchorage of osteosynthesis material in cancellous bone. Cancellous bone screws were inserted in bovine as well as in human vertebrae and human femoral condyles and were augmented with the new polymer or polymethylmethacrylate (PMMA), respectively. Nonaugmented screws were used as controls. A removal torque test, a dynamic fatigue test, and a pullout test were performed. Augmentation with the new polymer increased the removal torque by 84% in human femoral bone. In the dynamic fatigue test of bovine vertebrae, the removal torque after cyclic loading was 115% higher for the new polymer compared to the nonaugmented controls. In the human vertebrae, the reinforcement with the new polymer increased the removal torque after dynamic loading by 114%. The augmentation with the new polymer increased the pullout force by 88% in bovine vertebrae and by 118% in human vertebrae in comparison to nonaugmented screws. It was concluded that augmentation by the new resorbable polymer significantly enhanced the anchorage of bone screws in cancellous bone. The mechanical efficiency of the new polymer was comparable to that of PMMA cement.

Initial stability of fully and partially cemented femoral stems.

OBJECTIVE: To test the initial stability of a newly designed partially cemented femoral stem in comparison with a fully cemented conventional stem. DESIGN: An in vitro study to determine the interface motion between femoral stem and bone as a response to loading. BACKGROUND: The aim of the new prosthesis design is a proximal load transfer by a defined partial cement fixation in the proximal femur region and a slim prosthesis stem in the distal region. Before a clinical study can be started, the new stem has to show an initial stability comparable to that of fully cemented prostheses. METHOD: Six paired fresh cadaveric femora were used for the testing of the new partially cemented stem (Option 3000, Mathys Orthopaedics, Bettlach, Switzerland) and a fully cemented stem (Weber Shaft, AlloPro, Baar, Swizerland). Under cyclic loading up to 1600 N hip joint forces, the interface motion between implants and bone was measured at six locations. RESULTS: Both stems showed uncritical interface motions below 43 microm. However, the Option 3000 stem exhibited significantly smaller motions in the proximal region and slightly larger movements in the distal regions than the Weber prosthesis. CONCLUSIONS: The new type of partially cemented stem provided a comparable initial stability to the fully cemented Weber prosthesis. Relevance The high initial stability of the Option 3000 stem justified the clinical use of the new implant. More than 100 implantations in the last three years, with very good preliminary clinical results, support the preclinical findings.