Reinforcement Of Calcium Phosphate Cement Research Articles

Reinforcement of calcium phosphate cement using alkaline-treated silk fibroin.

BackgroundBone cement plays an important role in the treatment of osteoporotic vertebral compression fractures. Calcium phosphate cement (CPC) is a potential alternative to poly(methyl methacrylate), currently the gold standard of bone cements. However, the poor mechanical properties of CPCs limit their clinical applications. The objective of this study was to develop reinforced CPCs for minimally invasive orthopedic surgeries by compositing silk fibroin (SF) with α-tricalcium phosphate.MethodsSF solution was treated with calcium hydroxide and characterized by Zeta potential analyzer and Fourier transform infrared spectroscopy. The alkaline-treated SF (tSF) was com-posited with α-tricalcium phosphate to obtain tSF/CPC composite, which was characterized using mechanical tests, scanning electron microscopy, handling property and biocompatibility tests, and sheep vertebral augmentation tests.ResultsUpon treatment with calcium hydroxide, larger SF particles and more abundant negative charge appeared in tSF solution. The tSF/CPCs exhibited a compact structure, which consisted of numerous SF -CPC clusters and needle-like hydroxyapatite (HAp) crystals. In addition, high transition rate of HAp in tSF/CPCs was achieved. As a result, the mechanical property of tSF/ CPC composite cements was enhanced remarkably, with the compressive strength reaching as high as 56.3±1.1 MPa. Moreover, the tSF/CPC cements showed good injectability, anti-washout property, and decent biocompatibility. The tSF/CPCs could be used to augment defected sheep vertebrae to restore their mechanical strength.ConclusiontSF/CPC may be a promising composite bone cement for minimally invasive orthopedic surgeries.

Reinforcement of calcium phosphate cement by incorporating with high-strength β-tricalcium phosphate aggregates

Calcium phosphate cement (CPC) sets to form hydroxyapatite after implantation and has been used in orthopedic and dental procedures. However, the brittleness and low strength of CPC prohibit its use in many stress-bearing locations, and so the improvement of the compressive strength is one of the focuses of research on CPC. In this study, a novel way was used to improve the mechanical performance of CPC by dispersion of high-strength degradable β-tricalcium phosphate (β-TCP) granules sized between 200 μm and 450 μm in the cement as aggregates. Intimate bonding was formed between the aggregates and CPC matrix after hydration. The results showed that, by addition of 20 wt % the as-prepared β-TCP aggregates, the compressive strength of the calcium phosphate cement was increased by about 70%, while the paste of the CPC concrete still maintained injectable, and the heat release decreased obviously (about 25%) in the hydration process. The high strength or high rigidity of the β-TCP aggregates and good interfacial bonding between the aggregates and the CPC matrix seemed to contribute to the significant improvement in the mechanical performance.

Reinforcement of calcium phosphate cement with multi-walled carbon nanotubes and bovine serum albumin for injectable bone substitute applications

This paper presents the development of novel alternative injectable calcium phosphate cement (CPC) composites for orthopaedic applications. The new CPC composites comprise β -tri-calcium phosphate ( β -TCP) and di-calcium phosphate anhydrous (DCPA) mixed with bovine serum albumin (BSA) and incorporated with multi-walled carbon nanotubes (MWCNTs) or functionalized MWCNTs (MWCNTs–OH and MWCNTs–COOH). Scanning electron microscopy (SEM), compressive strength tests, injectability tests, Fourier transform infrared spectroscopy and X-ray diffraction were used to evaluate the properties of the final products. Compressive strength tests and SEM observations demonstrated particularly that the concomitant admixture of BSA and MWCNT improved the mechanical properties, resulting in stronger CPC composites. The presence of MWCNTs and BSA influenced the morphology of the hydroxyapatite (HA) crystals in the CPC matrix. BSA was found to act as a promoter of HA growth when bounded to the surface of CPC grains. MWCNT–OH-containing composites exhibited the highest compressive strengths (16.3 MPa), being in the range of values for trabecular bone (2–12 MPa).

Mechanical properties and in-vivo performance of calcium phosphate cement—chitosan fibre composite

Self-hardened calcium phosphate cement (CPC) sets to form hydroxyapatite and possesses excellent osteoconductivity. However, lack of macroporosity and low strength constrain its application in bone tissue engineering. Recent studies have incorporated various fibres into CPC to improve its mechanical strength. The present approach focused on the reinforcement of CPC with chitosan fibres and then the effects of the fibre structure on the mechanical properties and macrochannels formation characteristics of CPC-fibre composite were investigated. Chitosan fibres of diameter 200 microm were used to fabricate two types of three-dimensional structure, which were then coated with collagen and incorporated into CPC to fabricate CPC-fibre implants with a fibre volume content of 5 per cent. The compressive strength of the CPC-fibre implant was 33 MPa when the strain was 2.4 per cent, which is fourfold higher than that of the CPC control. Nine cylindrical implants including six CPC-fibre implants were implanted in the bone defects of nine dogs and were then post-operatively observed. After 20 weeks in vivo, new callus from the healthy tissue of the defect entirely integrated with the CPC-fibre implant and new bone was formed as the implant degraded. Scanning electronic microscopy images indicated that macrochannels were formed in the CPC-fibre implants with the degradation of fibres, but only micropores with a scale of less than 50 microm could be observed in the CPC control. Briefly, the incorporation of a suitable chitosan-fibre structure into a CPC implant not only could improve its mechanical properties but also facilitated the bone repair process in vivo.

Reinforcement of Calcium Phosphate Cement by Bio‐Mineralized Carbon Nanotube

Bio‐mineralized carbon natotubes (CNTs) were prepared by soaking carboxyl functionalized CNTs in a simulating body fluid (SBF). A uniform hydroxyapatite layer was precipitated on the outer walls of CNTs after 7 days of soaking. The results showed that, by addition of the as‐received CNTs and bio‐mineralized CNTs, the compressive strength of the calcium phosphate cement (CPC) increased by 24% and 120%, respectively. The modified interfacial bonding between the bio‐mineralized CNTs and CPC accounted for the significant improvement in the mechanical property by addition of the bio‐mineralized CNTs as compared with the as‐received CNTs.

Effects of fiber length and volume fraction on the reinforcement of calcium phosphate cement.

A self-setting calcium phosphate cement (CPC) transforms into solid hydroxyapatite during setting at body temperature, and has been used in a number of medical and dental procedures. However, the inferior mechanical properties of CPC prohibits its use in unsupported defects, stress-bearing locations or reconstruction of thin bones. The aim of the present study was to strengthen CPC with fiber reinforcement, to examine the effect of fiber length and volume fraction, and to investigate the reinforcement mechanisms. Previous studies employed either short fibers for random distributions, or continuous fibers that were as long as the specimen size with preferred orientations such as unidirectional alignment. In the present study, a novel methodology was developed in which fibers several times longer than the specimen mold size were randomly mixed with the CPC paste to approximate the isotropy associated with short fibers, and at the same time achieve the high reinforcement efficacy associated with continuous fibers. Carbon fibers of 8 microm diameter were used with fiber lengths ranging from 3 mm to 200 mm, and fiber volume fraction from 1.9% to 9.5%. A three-point flexural test was used to fracture the specimens. Scanning electron microscopy was used to examine crack-fiber interactions and specimen fracture surfaces. The composite containing fibers of 75 mm in length at a volume fraction of 5.7% achieved a flexural strength about 4 times, and work-of-fracture 100 times, greater than the unreinforced CPC. It is concluded that randomly mixing the CPC paste with carbon fibers that were several times longer than the specimen mold size resulted in substantial improvements in strength and fracture resistance; the reinforcement mechanisms were crack bridging and fiber pullout; and fiber length and volume fraction were key microstructural parameters that determined the cement properties.