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PubMed2004

Hydroxyapatite-based immobilized metal affinity adsorbents for protein purification.

The employment of metal ion-charged hydroxyapatite for the one-step purification of poly(His)-tagged recombinant proteins was investigated. Fe(III) showed the highest selectivity toward the poly(His)-tagged D-hydantoinase and the best operation stability. The optimal selectivity was observed in 20 mM pH 8.0 buffer containing 150 mM NaCl and 50 mM NaF. The adsorbed poly(His)-tagged enzyme could be quantitatively recovered from hydroxyapatite with 150 mM pH 8.0 phosphate buffer. The capacity of Fe(III)-loaded hydroxyapatite for poly(His)-tagged D-hydantoinase was 4.9 mg/g hydroxyapatite, comparable to commercial agarose-based Ni-NTA adsorbents. Under optimal conditions, a D-hydantoinase preparation with a purity above 95% from crude cellular lysate could be obtained with the one-step purification process employing Fe(III)-loaded hydroxyapatite. The application of Fe(III)-loaded hydroxyapatite for the purification of poly(His)-tagged N-acetyl-D-glucosamine 2-epimerase under denaturing conditions was also demonstrated. These results demonstrate that hydroxyapatite is a promising adsorbent for immobilized metal affinity chromatography.

Adsorption↗
PubMed2001

Formation of chloropyromorphite in a lead-contaminated soil amended with hydroxyapatite.

Conversion of soil Pb to pyromorphite [Pb5(PO4)3Cl] was evaluated by reacting a Pb contaminated soil collected adjacent to a historical smelter with hydroxyapatite [Ca5(PO4)3OH]. In a dialysis experiment where the soil and hydroxyapatite solids were placed in separate dialysis bags suspended in 0.01 M NaNO3 solution a crystalline precipitate, identified as chloropyromorphite, formed on the dialysis membrane containing the soil. The aqueous composition of the solution indicated that dissolution of solid-phase soil Pb was the rate-limiting step for pyromorphite formation. Addition of hydroxyapatite to the soil caused a decrease in each of the first four fractions of sequential extractable Pb and a 35% increase in the recalcitrant extraction residue. After a 240-d incubation at field-moisture content there was a further increase in the recalcitrant extraction residue fraction of the hydroxyapatite-amended soil to 45% of the total soil Pb. The increase in the extraction residue fraction in the hydroxyapatite amended 0-d incubated soil as compared to the control soil illustrates that the chemical extraction procedure itself caused changes in extractability. Thus, the chemical extraction procedure cannot easily be utilized to confirm changes occurring in amended soils. The further increase after the 240-d incubation implies that the reaction also occurs in the soil during incubation. Extended X-ray absorption fine structure (EXAFS) spectroscopy indicated that after the 240-d incubation the hydroxyapatite treatment caused a change in the average, local molecular bonding environment of soil Pb. Low-temperature EXAFS spectra (chi data and radial structure functions--RSFs) showed a high degree of similarity between the chemical extraction residue and synthetic pyromorphite, providing additional evidence that the change of soil Pb to pyromorphite is possible by simple amendments of hydroxyapatite to soil.

Absorptiometry, Photon↗
PubMed2002

Cadmium uptake by hydroxyapatite synthesized in different conditions and submitted to thermal treatment.

This paper intends to evaluate the uptake of cadmium ions from aqueous solution by 21 hydroxyapatite samples which have been synthesized in different conditions. It has been determined thatthe variation on the hydroxyapatite sorption capacity is neither related to sample solubility nor to hydroxyapatite Ca/P molar ratio. Cd2+ sorption is controlled by sample BET surface area, which shows a direct dependence on the hydroxyapatite crystallite dimensions. The hydroxyapatite pore distribution presented modes at 1000 and 60,000 A, corresponding to intracrystallite voids and voids between the agglomerate of these crystallites, respectively. Pores belonging to the former mode immobilize the major part of Cd2+. The influence of sample thermal treatment on Cd2+ sorption efficiency has been studied using hydroxyapatite samples calcined at temperatures ranging from 500 to 1140 degrees C. Similarly to nonthermally treat samples, the Cd2+ sorption on calcined hydroxyapatite could be described by Langmuir isotherms. The results showed that the maximum sorption capacity decreased from 0.631 mmol g(-1) for the noncalcined sample to 0.150 mmol g(-1) for the one calcined at 900 degrees C. This drop in the sorption capacity could also be explained by a reduction in its specific surface area, which is induced bythe increase of the crystal size.

Adsorption↗
PubMed1998

Tissue reaction of hydroxyapatite sol to rat molar pulp.

Hydroxyapatite sol was prepared by dispersing unheated hydroxyapatite microcrystals into distilled water. A suspension of hydroxyapatite heated at 800 degrees C (HAp-800 degrees C) in distilled water was used as a comparative material. These were characterized by X-ray diffractometry, SEM and electroconductivity measurements. 0.001 ml of each material was injected into the upper first molar pulp of rats. After 7-14 days post-operatively, the group with hydroxyapatite sol showed slight inflammation in the pulp cavities and a highly calcified tubular dentine bridge was observed. Osteodentine had developed and adhered to the surface of the hydroxyapatite microcrystals. Matrix vesicles were observed in the extracellular matrix between collagen fibrils and electron-dense granules. After 28 days, the inflammation completely disappeared and tubular dentine was observed below the osteodentine. Acid phosphates (ACPase) activity was detected along all biosynthesizing pathways in odontoblast-like cells. Localized dehydrogenate (LDH) activity indicated phagocytosis of hydroxyapatite microcrystals by odontoblasts. In the group with HAp-800 degrees C after 7-14 days post-operatively, the inflammation was moderate. After 28 days, relatively fewer calcified dentine tubules were observed. ACPase activity was detected only along the membranes bounding cytoplasmatic vacuoles. It was concluded that hydroxyapatite sol is a safe biomaterial for use as dental pulp and induces early formation of dentine-bridge more so than HAp-800 degrees C.

Journal Article↗
PubMed2000

An in vivo study on the reaction of hydroxyapatite-sol injected into blood.

In order to identify the possibility of hydroxyapatite-sol being used as a drug carrier and absorbent, an in vivo experimental study was performed. Pure hydroxyapatite microcrystals were synthesized by reaction of high purity Ca(OH)2 and H3PO4 solutions while using an ultrasonic homogenizer. Hydroxyapatite-sol was prepared by dispersing hydroxyapatite microcrystals into physiological salt solution. The hydroxyapatite-sol in different concentrations was injected into veins of both 25 Wistar rats and 5 Beagle dogs. The medium lethal dose was determined as 160 mg/kg. By observing the change of O2 and CO2 gas partial pressure, it was considered that the main cause of death by hydroxyapatite-sol injection was due to the blockage of capillaries. When one-sixth amount of the medium lethal dose was injected into the veins of the dogs, the value of phosphorous increased but calcium and magnesium kept stable. LDH, CPK, GOP and GDT values dramatically increased in 30 min after injection, however, one day after injection, the values returned to normal. Repeated experiments by similar methods were continued on same animals for 2 years in two-week intervals, the results in every experiment were almost same, no chronic damage or permanent side effects were discovered in the two years experiment. According to the results above, it was suggested that the hydroxyapatite-sol could be applied as a drug carrier into blood by using a small amount less than one-sixth of the medium lethal dose.

Journal Article↗
PubMed2002

Thermal decomposition of synthesised carbonate hydroxyapatite.

Heat treatments are used when sintering hydroxyapatite to make porous blocks and granules and during plasma spraying of coatings. Calcium : phosphorus ratio is known to affect the thermal decomposition behavior of hydroxyapatite. Hydroxyapatite with carbonate ions substituted for phosphate ions is more similar in composition to bone mineral. While it has been shown that carbonate apatite may be sintered, relatively little is known about its high temperature stability. Various atmospheres have been used in investigations into the thermal stability of hydroxyapatites and carbonate hydroxyapatites, including nitrogen, wet carbon dioxide air, water vapor and wet oxygen, but few of these studies were directly comparable. Previous work has shown that loss of carbonate from CHA at high temperature is time dependent, which suggests that rapid high temperature treatment may prevent carbonate loss during processing. This study investigated the effect of dry carbon dioxide, carbon dioxide containing 3% water, nitrogen and nitrogen containing 3% water on the phase composition of hydroxyapatite containing between 1.0 and 11.5 wt % carbonate rapidly heated to temperatures of between 700 and 1400 degrees C. Carbonate ion substitution was observed to decrease the temperature at which crystallisation occurred to a minimum of 700 degrees C for 11.8 wt % carbonate apatite heated in wet atmospheres. Atmosphere was found to appreciably affect the crystallization temperature and phase transformations of carbonate apatite containing 7.8 wt % carbonate. In wet and dry carbon dioxide atmospheres, crystallisation began in this material at 1100 and 900 degrees C, betaTCP was formed at 1500 and 1300 degrees C respectively. The high temperature decomposition of carbonate hydroxyapatite would appear to depend on the composition of the apatite and the atmosphere in which it is heated.

Journal Article↗
PubMed2001

Experience with 120 synthetic hydroxyapatite implants (FCI3).

PURPOSE: To assess the problems and/or complications associated with the use of a synthetic hydroxyapatite implant (FCI, Cedex, France). METHODS: The authors analyzed all of the problems and/or complications associated with the use of a third-generation synthetic hydroxyapatite implant (FCI3) in 120 patients by one surgeon over 4 years. The following data were recorded: age, type of surgery performed, size of implant used, peg system used, follow-up duration, time of pegging, problems and/or complications encountered, and treatment. RESULTS: Thirteen patients were lost to follow-up after 3 months, leaving 107 patients who were followed up from 4 to 48 months (average, 29 months). Discharge occurred in 21 (19.6%) patients, implant exposure in 3 (2.8%), socket discomfort in 2 (1.9%), trochleitis in 2 (1.9%), conjunctival thinning in 1 (0.93%), and pyogenic granuloma in 1 (0.93%). Peg problems occurred in 24 (35.2%) of 68 patients. Problems encountered with the peg were discharge in 10 (14.7%) patients, pyogenic granuloma in 9 (13.2%), conjunctiva overgrowing the peg in 4 (5.8%), hydroxyapatite exposure around the sleeve in 3 (4.4%), loose sleeve in 3 (4.4%), peg drilled on an angle in 1 (1.5%), implant infection in 1 (1.5%), and peg falling out in 1 (1.5%). CONCLUSIONS: The FCI3 synthetic hydroxyapatite is a less costly alternative form of hydroxyapatite currently in use in many parts of the world. Problems and complications encountered with its use are similar to those seen with the Bio-Eye Integrated Orbital Implants, Inc., San Diego, CA, U.S.A. The incidence of exposure associated with the synthetic hydroxyapatite implant is lower than several other reports on the Bio-Eye. The synthetic hydroxyapatite implant is slightly softer than the Bio-Eye and fractured under extreme pressure in one case.

Adult↗
PubMed1997

Hydroxyapatite and fluorapatite coatings for fixation of weight loaded implants.

Survivor analysis of total hip replacement recently has shown disappointing results in younger patients. To improve this, ceramic coatings have been applied to prostheses for cementless use. A new fluorine containing coating, fluorapatite, has been shown to increase bone ingrowth compared with hydroxyapatite in unloaded models. In a weight loaded model, the effects of hydroxyapatite and fluorapatite coated implants on implant fixation and bone ingrowth were evaluated. Eight hydroxyapatite and fluorapatite coated implants with porous surface were inserted into the medial femoral condyles of 8 mature dogs in a paired design. The implants initially were surrounded by a gap communicating with the joint space and were loaded during each gait cycle. After 25 weeks, no differences in pushout data or bone ingrowth between hydroxyapatite and fluorapatite coated implants were found. An important finding was the absence of foreign body reaction in the bone. Neither hydroxyapatite nor fluorapatite coatings delaminated during implantation or as a result of the pushout test. Bone repair activity remained in the initial gap zone, but most of the bone was of the lamellar type. No difference in bone remodeling between the hydroxyapatite and fluorapatite coated implants was found in the initial gap zone. Microprobe analysis showed no increase in fluorine content around the fluorapatite coated implants. The hydroxyapatite and fluorapatite coatings seem efficacious after a 25-week implantation period under weight loaded conditions.

Animals↗
PubMed2002

Relative contributions of chemistry and topography to the osseointegration of hydroxyapatite coatings.

The purpose of the current study was to ascertain the relative contributions of surface chemistry and topography to the osseointegration of hydroxyapatite-coated implants. A canine femoral intramedullary implant model was used to compare the osseous response to commercially pure titanium implants that were either polished, grit-blasted, plasma-sprayed with hydroxyapatite, or plasma-sprayed with hydroxyapatite and masked with a very thin layer of titanium using physical vapor deposition (titanium mask). The titanium mask isolated the chemistry of the underlying hydroxyapatite layer without functionally changing its surface topography and morphologic features. At 12 weeks, the bone-implant specimens were prepared for undecalcified thin section histologic evaluation and serial transverse sections were quantified with backscattered scanning electron microscopy for the percentage of bone apposition to the implant surface. Bone apposition averaged 3% for the polished implants and 23% for the grit-blasted implants. Bone apposition to the hydroxyapatite-coated implants averaged 74% whereas bone apposition to the titanium mask implants averaged 59%. Although there was significantly greater osseointegration with the hydroxyapatite-coated implants, 80% of the maximum bone forming response to the implant surfaces developed with the titanium mask implants. This simple, controlled experiment revealed that topography is the dominant factor governing bone apposition to hydroxyapatite-coated implants.

Animals↗
PubMed2006

Preparation and preliminary biological evaluation of 177Lu-labelled hydroxyapatite as a promising agent for radiation synovectomy of small joints.

AIM: Lutetium-(177)Lu) is considered to be a promising radionuclide for use in radiation synovectomy of small-sized joints owing to its favourable decay characteristics [t(1/2)=6.73 days, E(beta)(max)=0.49 MeV, E(gamma)=113 keV (6.4%), 208 keV (11%)] and feasible and cost-effective production route. Hydroxyapatite particles are regarded as one of the most suitable carriers for applications in radiation synovectomy, and labelling with (177)Lu has been envisaged. The present work describes the preparation and preliminary biological evaluation of (177)Lu-labelled hydroxyapatite particles. METHODS: (177)Lu-labelled hydroxyapatite particles were prepared using (177)Lu produced by thermal neutron irradiation of a natural (2.6% (177)Lu) Lu(2)O(3) target and hydroxyapatite particles (particle size, 2-10 microm) prepared in-house. The biological efficacy of the radiolabelled preparation was tested by recording serial gamma scintigraphic images after injecting the agent in both normal and arthritic knee joints of Wistar rats. RESULTS: (177)Lu-hydroxyapatite was prepared with high yield and high radiochemical purity (approximately 99%) and the radiolabelled particles showed excellent in-vitro stability at room temperature. Serial scintigraphic images of normal and arthritic Wistar rats showed complete retention of activity within the synovial cavity, with no measurable activity leaching out from the joint until 168 h post-injection. CONCLUSION: Studies with (177)Lu-hydroxyapatite indicate its potential for use as an agent for radiation synovectomy of digital joints, as a viable alternative to (169)Er-based agents. The results also demonstrate the possibility of preparing a large number of patient doses of (177)Lu-hydroxyapatite from indigenously produced (177)Lu using a natural target.

Animals↗
PubMed2007

A hydroxyapatite graft substitute reduces subsidence in a femoral impaction grafting model.

Synthetic bone graft substitutes have been developed for impaction grafting revision hip surgery in response to concerns about the availability and potential infection risk of allograft. We performed an in vitro experiment to determine whether a synthetic porous hydroxyapatite material might improve resistance to cumulative subsidence and cyclic (elastic) movement on loading. We impacted different ratios of hydroxyapatite and allograft (0%, 50%, 70%, and 90% hydroxyapatite) into composite femoral models (eight per group) and implanted tapered, polished stems with cement. Models were loaded for 18,000 cycles on a servohydraulic materials testing machine. Migration of the femoral prostheses and the distal cement was determined using radiostereometric analysis, and cyclic movement was measured mechanically by the testing machine. Hydroxyapatite decreased overall subsidence and subsidence at the prosthesis-cement interface, but there was no difference at the cement-femur interface. This decrease may have occurred because the hydroxyapatite-containing graft was more rigid, or because it resulted in a thicker cement mantle. Cyclic prosthesis movement also was lower with hydroxyapatite. While the biologic response to porous hydroxyapatite remains to be determined, its mechanical properties appear promising.

Arthroplasty, Replacement, Hip↗
PubMed1996

Temporal and compositional characteristics of salivary protein adsorption to hydroxyapatite.

Salivary proteins bind to enamel surfaces and hydroxyapatite in a highly selective manner. Numerous studies have identified these proteins as primarily proline-rich proteins, cystatins, statherin, and histatins. Previously, the hydroxyapatite-binding potential of these proteins had been characterized in systems consisting of singly purified protein and adsorbent. The purpose of this study was to investigate the adsorption of each protein in the presence of complete salivary secretion. Proteins, shown to adsorb to hydroxyapatite, were purified, biotinylated, and added back to the remaining proteins to form a series of reconstituted secretions. The adsorption of each biotinylated protein in the reconstituted secretion to hydroxyapatite was then measured as a function of time. Results indicated that three different adsorption patterns occur. A simple hyperbolic pattern is characteristic of amylase, glycosylated proline-rich protein (PRG), and cystatin. A faster adsorption process is observed for PRP-3, PRP-4, PIF-f, and statherin. A more complex pattern, exhibiting a rapid phase followed by a slower phase, is characteristic of PRP-1, PRP-2, PIF-s, and histatins. These results suggest that there are different adsorption processes involved in the binding of salivary proteins to hydroxyapatite. Two possible mechanisms are direct adsorption of protein to hydroxyapatite and indirect adsorption of protein by interacting with other proteins already bound to hydroxyapatite.

Adsorption↗
PubMed1999

Enhancement by recombinant human bone morphogenetic protein-2 of bone formation by means of porous hydroxyapatite in mandibular bone defects.

Hydroxyapatite is osteoconductive and can maintain an original biocompatible form. It is useful, in the reconstruction of bone defects, to enhance the osteoconduction of hydroxyapatite with an osteogenic protein. The aim of this study was to evaluate the bone formation in surgically created defects of rabbit mandibles by a combination of recombinant human bone morphogenetic protein-2 (rhBMP-2), with porous hydroxyapatite and atelopeptide type I collagen used as the carrier for rhBMP-2. A 10-microg rhBMP-2-implanted group (n = 15) and a control group (n = 15), in which only atelopeptide type I collagen and porous hydroxyapatite were implanted, were histologically examined 3, 7, and 21 days after implantation. The alkaline phosphatase activity was also quantitatively analyzed. No new bone formation was observed in either the tested or the control group after 3 days. At 7 days, immature bone tissue was observed in some pores of the rhBMP-2implanted group, while in the control group, immature mesenchymal cells were observed. At 21 days, trabecular bone lined some pore walls. In the central portion, the bone marrow, including angioid tissue, was observed. New trabecular bone formation was observed on portions of the external surface of the hydroxyapatite disk. On the other hand, the control group showed infiltration of immature mesenchymal cells into some pores. Marginal bone formation was found in the pores close to the surface of the disk which opposed mandibular bone. The control group showed a slow, small increase in alkaline phosphatase activity in this study, while the experimental group showed a marked increase at 21 days. This increase was significantly higher in the tested group than in the control group at both 7 and 21 days. The findings indicate that rhBMP-2 accelerated bone formation by osteoconduction from porous hydroxyapatite. The combination of rhBMP-2, atelopeptide type I collagen, and porous hydroxyapatite is suggested to be advantageous for clinical application in reconstructing mandibular bone defects.

Alkaline Phosphatase↗
PubMed1998

The effect of hydroxyapatite on the micromotion of total knee prostheses. A prospective, randomized, double-blind study.

A prospective, randomized, double-blind study was performed to evaluate three different means of fixing tibial components during total knee arthroplasty. Eleven components fixed with cement, ten hydroxyapatite-coated components fixed without cement, and ten noncoated components fixed without cement were studied. A posterior cruciate ligament-retaining total condylar implant was used. Micromotion of the components was assessed with roentgen stereophotogrammetric analysis during the two-year follow-up period. There were no significant differences among the patients with regard to age (mean [and standard deviation], 68 +/- 11.6 years), body-mass index (mean, 23 +/- 2.8 kilograms per square meter), or stage of osteoarthrosis (mean, 4 +/- 2.4 according to the classification system of Ahlback and 5 +/- 0.6 according to that of Larsen et al.). The diagnosis was osteoarthrosis in five knees, and it was rheumatoid arthritis in twenty-six. The clinical scores were similar among the study groups. According to the system of the Knee Society, the mean preoperative functional score was 10 +/- 2.9 points and the mean preoperative knee score was 24 +/- 3.2 points. At the two-year follow-up evaluation, these scores were 41 +/- 8.3 and 79 +/- 3.2 points, respectively. A significant difference with regard to micromotion was found between the noncoated components fixed without cement and the hydroxyapatite-coated components fixed without cement as well as between the noncoated components fixed without cement and the components fixed with cement (p < 0.001, analysis of variance). The hydroxyapatite-coated components fixed without cement and the components fixed with cement both had far less micromotion along the longitudinal axis (subsidence) throughout the follow-up period than did the noncoated components fixed without cement. At the two-year follow-up evaluation, the subsidence of the noncoated components was -0.73 +/- 0.924 millimeter, the subsidence of the cemented components was -0.05 +/- 0.109 millimeter, and the subsidence of the hydroxyapatite-coated components was -0.06 +/- 0.169 millimeter. The cemented components as well as the hydroxyapatite-coated components also had less translation along the transverse axis (p < 0.001, analysis of variance) and the sagittal axis (p < 0.001, analysis of variance) compared with the noncoated components. In conclusion, micromotion of hydroxyapatite-coated tibial components fixed without cement was similar to that of tibial components fixed with cement. Therefore, hydroxyapatite, a biological mediator, may be necessary for the adequate fixation of tibial components when cement is not used.

Aged↗
PubMed2001

Improvement of the bone-pin interface strength in osteoporotic bone with use of hydroxyapatite-coated tapered external-fixation pins. A prospective, randomized clinical study of wrist fractures.

BACKGROUND: Achieving adequate fixation strength in osteoporotic bone is a challenge. In this study, we examined the use of hydroxyapatite-coated tapered external-fixation pins for the fixation of wrist fractures in patients with osteoporosis. METHODS: Twenty female patients with osteoporosis and a fracture of the wrist were divided into two paired groups and randomized to receive either standard tapered pins or hydroxyapatite-coated tapered pins. Two pins were inserted in the distal part of the radius, two pins were inserted in the second metacarpal, and an external fixation device was mounted. All fixation devices were removed six weeks after surgery. RESULTS: The mean pin-insertion torque (and standard deviation) was 461 +/- 254 Nmm in the group managed with standard pins and 332 +/- 176 Nmm in the group managed with hydroxyapatite-coated pins (p = 0.01). The mean pin-extraction torque was 191 +/- 155 Nmm in the group managed with standard pins and 600 +/- 214 Nmm in the group managed with hydroxyapatite-coated pins (p < 0.0001, power 95%). The mean extraction torque was lower than the corresponding insertion torque at each pin position in the group managed with standard pins (p < 0.05), whereas the mean extraction torque was higher than the corresponding insertion torque at each pin position in the group managed with hydroxyapatite-coated pins (p = 0.001). Two patients managed with standard pins and no patient managed with hydroxyapatite-coated pins had a pin-track infection. Pain during pin removal did not differ between the two groups. CONCLUSIONS: The present study showed that hydroxyapatite-coated tapered external-fixation pins provided improved fixation in the treatment of wrist fractures in patients with osteoporosis.

Aged↗
PubMed2002

Alendronate does not inhibit early bone apposition to hydroxyapatite-coated total joint implants: a preliminary study.

BACKGROUND: Alendronate is a pyrophosphate analogue of bisphosphonate that has been shown to inhibit osteoclastic bone resorption. Bone formation and remodeling are necessary to establish initial fixation of uncemented implants, especially those coated with a bioactive surface such as hydroxyapatite. Because the process of bone-remodeling that culminates in new-bone formation is thought to be initiated by osteoclastic bone resorption, it is appropriate to test the influence of osteoclast-inhibiting medications on bone apposition to hydroxyapatite-coated implants. METHODS: Twelve dogs underwent staged bilateral total hip arthroplasty, with twenty weeks between the first and second operations, with use of a titanium-alloy femoral stem that had a proximal macrotextured surface and a plasma-sprayed hydroxyapatite coating. Six of the dogs received oral alendronate therapy from the time of the surgery until they were killed; the other six dogs were untreated controls. The animals were killed four weeks after the second operation. Sections from matched implant sites (proximal, middle, and distal) were histologically analyzed. The linear extent of bone apposition, the linear extent and the thickness of the hydroxyapatite coating, and the total amount of cortical and trabecular bone were measured with the use of an interactive image analysis system. RESULTS: There were no significant differences in radiographic or histologic findings between the two groups at either four or twenty-four weeks. Although the extent of the hydroxyapatite coating decreased significantly with time in both groups (p < 0.01), we identified no significant influence of alendronate on the extent of bone apposition, the extent or thickness of the hydroxyapatite coating, or the cortical or trabecular bone area around the implants. CONCLUSIONS: Many patients who are receiving alendronate for osteoporosis or other disorders may also be candidates for cementless total joint arthroplasty. Although bone formation is generally thought to be initiated by and coupled with bone resorption, our results suggest that alendronate has no discernible effect on the initial fixation of or the short-term bone-remodeling around hydroxyapatite-coated femoral total joint implants.

Alendronate↗
PubMed2002

Hydroxyapatite-coated Schanz pins in external fixators used for distraction osteogenesis : a randomized, controlled trial.

BACKGROUND: Complications of external fixation include loosening of the fixation pins and pin-track infection. Laboratory studies and clinical trials have suggested that hydroxyapatite coating improves the osteointegration of various orthopaedic implants. The purpose of this study was to determine whether the prevalence of pin-related complications can be reduced by the use of hydroxyapatite-coated pins in fixators applied for distraction osteogenesis. METHODS: Forty-six consecutive patients undergoing segmental transport or lengthening of the tibia were randomized to the use of either standard titanium Schanz pins or hydroxyapatite-coated stainless-steel Schanz pins. The fixators were used for an average of thirty-eight weeks (range, fourteen to seventy-two weeks). All patients were closely monitored for pin loosening and infection, and digitized radiographs were assessed for bone resorption around all pins. When the external fixator was removed, the torque required to extract the pins was determined with use of an electronic torque wrench. RESULTS: In the control group (titanium pins), twenty-two pins (13%) loosened and an infection occurred at the site of twenty pins. An extensive infection of the canal developed in one patient. Twenty-two pins were removed or replaced because of these complications. In the hydroxyapatite group, no clinical or radiographic signs of pin loosening or infection were observed and no pins required early removal or exchange. The mean torque (and standard deviation) required to remove the hydroxyapatite-coated pins was 0.43 0.18 N-m compared with 0.10 0.09 N-m for the uncoated pins (p < 0.001). CONCLUSION: Coating pins with hydroxyapatite increases their fixation to bone and reduces the rate of infection and loosening during external fixation for distraction osteogenesis. Use of hydroxyapatite-coated pins should be considered in clinical situations requiring prolonged external fixation.

Adolescent↗
PubMed2003

Enhanced bioactivity of a poly(propylene fumarate) bone graft substitute by augmentation with nano-hydroxyapatite.

The bioactivity of a nano-hydroxyapatite-augmented, bioresorbable bone graft substitute made from the unsaturated polyester, poly(propylene fumarate), was analyzed by evaluating biocompatibility and osteointegration of implants placed into a rat tibial defect. Three groups of eight animals each were evaluated by grouting bone graft substitutes into 3-mm holes that were made into the anteromedial tibial metaphysis of rats. Thus, a total of 24 animals was included in this study. Two different formulations varying as to the type of hydroxyapatite were used: Group 1 - nano-hydroxyapatite, Group 2 - micron-hydroxyapatite, with a Group 3 control defect remaining unfilled. Animals of each of the three groups were sacrificed in groups of eight at postoperative week three. Histologic analysis revealed best superior biocompatibility and osteointegration of bone graft substitutes when nanohydroxyapatite was employed. At three weeks, there was more reactive new bone formation in this group when compared to the micron-hydroxyapatite group. The control group showed incomplete closure of the defect. This study suggested that nano-hydroxyapatite may improve upon the bioactivity of bone implant and repair materials. The model scaffold used in this study, poly(propylene fumarate), appeared to provide an osteoconductive pathway by which bone will grow in faster. Clinical implications of the use potential advantages of nano-hydroxyapatite on bone repair and orthopaedic implant design are discussed.

Absorbable Implants↗