Abstract
The present work describes the synthesis of novel injectable, self-setting bone cements made of strontium-substituted hydroxyapatite (Sr-HA), obtained by single-phase calcium phosphate precursors doped with different amounts of strontium and enriched with alginate. The addition of alginate improved the injectability, cohesion, and compression strength of the cements, without affecting the hardening process. A Sr-HA cement exhibiting adequate hardening times and mechanical strength for clinical applications was further tested in vivo in a rabbit model, in comparison with a commercial calcium phosphate cement, revealing the maintenance of biomimetic composition and porous microstructure even after one month in vivo, as well as enhanced ability to induce new bone formation and penetration.
Highlights
The development of injectable and self-hardening biomaterials able to regenerate damaged bones by minimal invasive surgery is a topic of increasing interest, for the treatment of vertebral fractures [1,2,3,4,5], and tibial plateau, proximal humerus, wrist and calcaneus [6], as well as hip and femoral neck [7].In this respect, complete bone regeneration still remains an unsolved clinical need, mainly due to the unavailability of bone cements endowed with adequate bioactivity, porosity, and osteoconductivity able to promote effective new bone formation and extensive cell proliferation upon hardening
calcium phosphate bone cements (CPCs) are considered as elective candidates for bone regeneration due to their excellent biocompatibility, chemical similarity with bone tissue, and ability to harden in vivo at body temperature
Sr-substituted αTCP phases were synthesized as a unique inorganic
Summary
The development of injectable and self-hardening biomaterials able to regenerate damaged bones by minimal invasive surgery is a topic of increasing interest, for the treatment of vertebral fractures [1,2,3,4,5], and tibial plateau, proximal humerus, wrist and calcaneus [6], as well as hip and femoral neck [7]. A major challenge for material scientists is the control of the chemistry and rheological properties of injectable CPCs; process parameters, such as phase composition of the inorganic precursor, particle size, liquid-on-powder ratio (L/P), polymeric additives are critical factors affecting their viscosity, cohesion, and setting times [15]. In this respect, previous research reported improved cement injectability and cohesion by decreasing the particle size of the starting powders, as well as using more viscous solutions. The in vivo performance of a selected cement formulation was preliminary evaluated at four weeks after surgery into rabbit femur, in comparison with a commercial CPC, by compositional, morphological, and histological/histomorphometric analysis
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