Abstract
Calcium phosphate cements (CPCs) are synthetic bone grafting materials that can be used in fracture stabilization and to fill bone voids after, e.g., bone tumour excision. Currently there are several calcium phosphate-based formulations available, but their use is partly limited by a lack of knowledge of their mechanical properties, in particular their resistance to mechanical loading over longer periods of time. Furthermore, depending on, e.g., setting conditions, the end product of acidic CPCs may be mainly brushite or monetite, which have been found to behave differently under quasi-static loading. The objectives of this study were to evaluate the compressive fatigue properties of acidic CPCs, as well as the effect of phase composition on these properties. Hence, brushite cements stored for different lengths of time and with different amounts of monetite were investigated under quasi-static and dynamic compression. Both storage and brushite-to-monetite phase transformation was found to have a pronounced effect both on quasi-static compressive strength and fatigue performance of the cements, whereby a substantial phase transformation gave rise to a lower mechanical resistance. The brushite cements investigated in this study had the potential to survive 5 million cycles at a maximum compressive stress of 13 MPa. Given the limited amount of published data on fatigue properties of CPCs, this study provides an important insight into the compressive fatigue behaviour of such materials.
Highlights
Bone tissue has a certain ability to heal by itself, if a fracture has reached a critical size, or if the bone tissue is of poor quality, bone grafting may be needed
To achieve specimens with plane parallel end surfaces, the set specimens were polished with SiC paper to a final height of 12 mm
It was found that pre-set acidic cements have the potential to survive 5 million cycles under compressivecompressive fatigue at a maximum stress of 13 MPa
Summary
Bone tissue has a certain ability to heal by itself, if a fracture has reached a critical size, or if the bone tissue is of poor quality, bone grafting may be needed. The global market for bone grafts and substitutes was estimated to almost 2.4 billion US$ in 2014 [1]. With an aging population and an increasing number of patients suffering from osteoporosis the bone graft substitute market is anticipated to continue to rise [2]. Among the synthetic bone grafting materials, calcium phosphate cements (CPCs) are an interesting alternative since they can be degradable, are osteoconductive and can be directly injected into the fracture site [3, 4]. Limiting factors for an increased use of CPCs in fracture stabilization and as a bone-void filling material, include a strong tradition to use autografts, restricted knowledge about different synthetic alternatives [6], and, perhaps most importantly, their mechanical properties [5]
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