Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery

Esther M M Van Lieshout; Gerdine H Van Kralingen; Youssef El-Massoudi; Harrie Weinans; Peter Patka

doi:10.1186/1471-2474-12-34

Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery

Esther M M Van Lieshout^*
, Gerdine H Van Kralingen
, Youssef El-Massoudi
, Harrie Weinans
, Peter Patka

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Many (artificial) bone substitute materials are currently available for use in orthopaedic trauma surgery. Objective data on their biological and biomechanical characteristics, which determine their clinical application, is mostly lacking. The aim of this study was to investigate structural and in vitro mechanical properties of nine bone substitute cements registered for use in orthopaedic trauma surgery in the Netherlands.

METHODS: Seven calcium phosphate cements (BoneSource®, Calcibon®, ChronOS®, Eurobone®, HydroSet™, Norian SRS®, and Ostim®), one calcium sulphate cement (MIIG® X3), and one bioactive glass cement (Cortoss®) were tested. Structural characteristics were measured by micro-CT scanning. Compression strength and stiffness were determined following unconfined compression tests.

RESULTS: Each bone substitute had unique characteristics. Mean total porosity ranged from 53% (Ostim®) to 0.5% (Norian SRS®). Mean pore size exceeded 100 μm only in Eurobone® and Cortoss® (162.2 ± 107.1 μm and 148.4 ± 70.6 μm, respectively). However, 230 μm pores were found in Calcibon®, Norian SRS®, HydroSet™, and MIIG® X3. Connectivity density ranged from 27/cm3 for HydroSet™ to 0.03/cm3 for Calcibon®. The ultimate compression strength was highest in Cortoss® (47.32 MPa) and lowest in Ostim® (0.24 MPa). Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa).

CONCLUSIONS: The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications. The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.

Original language	English
Article number	34
Journal	BMC Musculoskeletal Disorders
Volume	12
DOIs	https://doi.org/10.1186/1471-2474-12-34
Publication status	Published - 2 Feb 2011
Externally published	Yes

Keywords

Biomechanical Phenomena
Bone Cements/chemistry
Bone Substitutes/chemistry
Bone and Bones/diagnostic imaging
Humans
Materials Testing/methods
Orthopedic Procedures/instrumentation
Radiography
Wounds and Injuries/physiopathology

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10.1186/1471-2474-12-34

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@article{6a6dc30742994b318fc41f9e309db604,

title = "Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery",

abstract = "BACKGROUND: Many (artificial) bone substitute materials are currently available for use in orthopaedic trauma surgery. Objective data on their biological and biomechanical characteristics, which determine their clinical application, is mostly lacking. The aim of this study was to investigate structural and in vitro mechanical properties of nine bone substitute cements registered for use in orthopaedic trauma surgery in the Netherlands.METHODS: Seven calcium phosphate cements (BoneSource{\textregistered}, Calcibon{\textregistered}, ChronOS{\textregistered}, Eurobone{\textregistered}, HydroSet{\texttrademark}, Norian SRS{\textregistered}, and Ostim{\textregistered}), one calcium sulphate cement (MIIG{\textregistered} X3), and one bioactive glass cement (Cortoss{\textregistered}) were tested. Structural characteristics were measured by micro-CT scanning. Compression strength and stiffness were determined following unconfined compression tests.RESULTS: Each bone substitute had unique characteristics. Mean total porosity ranged from 53\% (Ostim{\textregistered}) to 0.5\% (Norian SRS{\textregistered}). Mean pore size exceeded 100 μm only in Eurobone{\textregistered} and Cortoss{\textregistered} (162.2 ± 107.1 μm and 148.4 ± 70.6 μm, respectively). However, 230 μm pores were found in Calcibon{\textregistered}, Norian SRS{\textregistered}, HydroSet{\texttrademark}, and MIIG{\textregistered} X3. Connectivity density ranged from 27/cm3 for HydroSet{\texttrademark} to 0.03/cm3 for Calcibon{\textregistered}. The ultimate compression strength was highest in Cortoss{\textregistered} (47.32 MPa) and lowest in Ostim{\textregistered} (0.24 MPa). Young's Modulus was highest in Calcibon{\textregistered} (790 MPa) and lowest in Ostim{\textregistered} (6 MPa).CONCLUSIONS: The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications. The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.",

keywords = "Biomechanical Phenomena, Bone Cements/chemistry, Bone Substitutes/chemistry, Bone and Bones/diagnostic imaging, Humans, Materials Testing/methods, Orthopedic Procedures/instrumentation, Radiography, Wounds and Injuries/physiopathology",

author = "\{Van Lieshout\}, \{Esther M M\} and \{Van Kralingen\}, \{Gerdine H\} and Youssef El-Massoudi and Harrie Weinans and Peter Patka",

year = "2011",

month = feb,

day = "2",

doi = "10.1186/1471-2474-12-34",

language = "English",

volume = "12",

journal = "BMC Musculoskeletal Disorders",

issn = "1471-2474",

publisher = "BioMed Central",

}

TY - JOUR

T1 - Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery

AU - Van Lieshout, Esther M M

AU - Van Kralingen, Gerdine H

AU - El-Massoudi, Youssef

AU - Weinans, Harrie

AU - Patka, Peter

PY - 2011/2/2

Y1 - 2011/2/2

N2 - BACKGROUND: Many (artificial) bone substitute materials are currently available for use in orthopaedic trauma surgery. Objective data on their biological and biomechanical characteristics, which determine their clinical application, is mostly lacking. The aim of this study was to investigate structural and in vitro mechanical properties of nine bone substitute cements registered for use in orthopaedic trauma surgery in the Netherlands.METHODS: Seven calcium phosphate cements (BoneSource®, Calcibon®, ChronOS®, Eurobone®, HydroSet™, Norian SRS®, and Ostim®), one calcium sulphate cement (MIIG® X3), and one bioactive glass cement (Cortoss®) were tested. Structural characteristics were measured by micro-CT scanning. Compression strength and stiffness were determined following unconfined compression tests.RESULTS: Each bone substitute had unique characteristics. Mean total porosity ranged from 53% (Ostim®) to 0.5% (Norian SRS®). Mean pore size exceeded 100 μm only in Eurobone® and Cortoss® (162.2 ± 107.1 μm and 148.4 ± 70.6 μm, respectively). However, 230 μm pores were found in Calcibon®, Norian SRS®, HydroSet™, and MIIG® X3. Connectivity density ranged from 27/cm3 for HydroSet™ to 0.03/cm3 for Calcibon®. The ultimate compression strength was highest in Cortoss® (47.32 MPa) and lowest in Ostim® (0.24 MPa). Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa).CONCLUSIONS: The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications. The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.

AB - BACKGROUND: Many (artificial) bone substitute materials are currently available for use in orthopaedic trauma surgery. Objective data on their biological and biomechanical characteristics, which determine their clinical application, is mostly lacking. The aim of this study was to investigate structural and in vitro mechanical properties of nine bone substitute cements registered for use in orthopaedic trauma surgery in the Netherlands.METHODS: Seven calcium phosphate cements (BoneSource®, Calcibon®, ChronOS®, Eurobone®, HydroSet™, Norian SRS®, and Ostim®), one calcium sulphate cement (MIIG® X3), and one bioactive glass cement (Cortoss®) were tested. Structural characteristics were measured by micro-CT scanning. Compression strength and stiffness were determined following unconfined compression tests.RESULTS: Each bone substitute had unique characteristics. Mean total porosity ranged from 53% (Ostim®) to 0.5% (Norian SRS®). Mean pore size exceeded 100 μm only in Eurobone® and Cortoss® (162.2 ± 107.1 μm and 148.4 ± 70.6 μm, respectively). However, 230 μm pores were found in Calcibon®, Norian SRS®, HydroSet™, and MIIG® X3. Connectivity density ranged from 27/cm3 for HydroSet™ to 0.03/cm3 for Calcibon®. The ultimate compression strength was highest in Cortoss® (47.32 MPa) and lowest in Ostim® (0.24 MPa). Young's Modulus was highest in Calcibon® (790 MPa) and lowest in Ostim® (6 MPa).CONCLUSIONS: The bone substitutes tested display a wide range in structural properties and compression strength, indicating that they will be suitable for different clinical indications. The data outlined here will help surgeons to select the most suitable products currently available for specific clinical indications.

KW - Biomechanical Phenomena

KW - Bone Cements/chemistry

KW - Bone Substitutes/chemistry

KW - Bone and Bones/diagnostic imaging

KW - Humans

KW - Materials Testing/methods

KW - Orthopedic Procedures/instrumentation

KW - Radiography

KW - Wounds and Injuries/physiopathology

U2 - 10.1186/1471-2474-12-34

DO - 10.1186/1471-2474-12-34

M3 - Article

C2 - 21288333

SN - 1471-2474

VL - 12

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

M1 - 34

ER -

Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery

Abstract

Keywords

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