Abstract
In this work a radiopaque premixed calcium phosphate cement (pCPC) has been developed and evaluated in vivo. Radiopacity was obtained by adding 0–40 % zirconia to the cement paste. The effects of zirconia on setting time, strength and radiopacity were evaluated. In the in vivo study a 2 by 3.5 mm cylindrical defect in a rat vertebrae was filled with either the pCPC, PMMA or bone chips. Nano-SPECT CT analysis was used to monitor osteoblast activity during bone regeneration. The study showed that by adding zirconia to the cement the setting time becomes longer and the compressive strength is reduced. All materials evaluated in the in vivo study filled the bone defect and there was a strong osteoblast activity at the injury site. In spite of the osteoblast activity, PMMA blocked bone healing and the bone chips group showed minimal new bone formation. At 12 weeks the pCPC was partially resorbed and replaced by new bone with good bone ingrowth. The radiopaque pCPC may be considered to be used for minimal invasive treatment of vertebral fractures since it has good handling, radiopacity and allows healing of cancellous bone in parallel with the resorption of the cement.
Highlights
Due to an aging population together with a lifestyle that requires less movement, many elderly today have weak bone structure
Calcium phosphate cements (CPCs), which were first presented in the beginning of the 80s [4, 5], are alternatives to PMMA
CPCs consist of calcium phosphate salts, which upon mixing with water dissolve and precipitate to form a solid body of either brushite or apatite depending on the pH of the solution [4]
Summary
Due to an aging population together with a lifestyle that requires less movement, many elderly today have weak bone structure. There are complications associated with the use of PMMA, such as cement leakage and increased risk of adjacent fractures [2, 3], so there is increased interest in finding alternative materials. Calcium phosphate cements (CPCs), which were first presented in the beginning of the 80s [4, 5], are alternatives to PMMA. An innovative approach was taken where water was exchanged for glycerol as mixing liquid [14]. This gives the surgeon unlimited time for the injection, and the viscosity remains constant until the premixed calcium phosphate cement (pCPC) is in place and the cement comes in contact with water. The premixed concept has been shown to work on both brushite and apatite cements [14,15,16]
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