Calcium Sulfate Bone Void Filler: A Review and a Look Ahead

2000 ◽  
Vol 11 (4) ◽  
pp. 327-333 ◽  
Author(s):  
William S. Pietrzak ◽  
Robert Ronk
Keyword(s):  
Calcium Sulfate ◽  
Look Ahead ◽  
Bone Void Filler ◽  
Bone Void

scholarly journals Reconstruction of anterior frontal wall and contours defects using bone substitute

2021 ◽  
pp. 34
Author(s):  
Keyword(s):  
Bone Substitute ◽  
Calcium Sulfate ◽  
Donor Site ◽  
Bone Defects ◽  
Autogenous Bone ◽  
Bone Void Filler ◽  
Custom Made ◽  
Cranial Implant ◽  
Bone Void ◽  
Orbital Area

Aim: The aim of this article is to report on the safety and long-term efficacy of Cerament® BoneVoid Filler bone substitute for repairing craniofacial bone defects. Post-traumatic cranioplasty is a complex and challenging procedure for all maxillo-craniofacial surgeons and neurosurgeons, especially when repairing large areas. The standard criterion for repairing small cranial defects is the use autogenous bone from the iliac crest or split calvarial grafts. Autogenous grafts may result in donor-site morbidity, increased surgical time, reabsorption, blood loss, and longer recovery time . Alloplastic materials used for bone repair, such as methyl methacrylate, hydroxyapatite, titanium, or porous polyethylene, are expected to have optimal properties, including easy adaptation, biocompatibility, ingrowth of new tissue, stability of shape, and low rate of reabsorption. A cranial implant should be easily shaped and positioned, allowing easy tissue growth. In very wide cranium defects the new technology is a custom made cranial implant constructed three-dimensionally with different types of materials. However, this procedure is very expensive with various infection rates depending on the kind of material used and on the chemicophysical composition of the implant. Methods: The authors report the case of a 50-year-old man with a severe deformity of the forehead-supra orbital area as a result of a previous complex fronto-facial trauma treated in an emergency Unit. Secondary correction and reconstruction of the residual deformities were performed by using Cerament® Bone Void Filler, an alloplastic biphasic material, composed of 40% hydroxyapatite, 60% calcium sulfate and the radio-contrast agent iohexol. The unique ratio of hydroxyapatite and calcium sulfate is designed to enable Cerament to resorb at the same rate that bone forms. Calcium sulfate acts as a resorbable carrier for hydroxyapatite which is highly osteoconductive, promoting bone ingrowth.It seems to be a promising bone graft substitute in the management of bony irregularities in the fronto-orbital area. Conclusion: The patient was first hospitalized as the result of a serious craniofacial trauma. One year after the first emergency cranio-orbital reconstructive operation, a marked deformity of the frontal region appeared with a “grid effect” due to the inadequate plate-bony fixation of the fractures applied during the first bony recomposition and because it was not as rigid as it should have been . A secondary surgery for deformity correction was performed. The hardware was totally removed and the bony deformity smoothed, reshaped, covered and filled using Cerament® Bone Void Filler, a biomaterial. The patient recovered with a satisfactory cranium-forehead shape, no complications, and complete disappearance of a frowning look of the fronto-orbital region. Recently, increased use of bone substitutes in the reconstruction of bone defects has been fuelled by donor site complications associated with autologous bone harvesting. Cerament® BoneVoid Filler is a biphasic and injectable bone substitute that has a highly compressive strength and the ability to promote cancellous bone healing

The Treatment of Chronic Osteomyelitis with a Biodegradable Antibiotic-Impregnated Implant

2002 ◽  
Vol 10 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Steven Gitelis ◽  
Gregory T. Brebach
Keyword(s):  
Dead Space ◽  
Calcium Sulfate ◽  
Bone Repair ◽  
Chronic Osteomyelitis ◽  
Attractive Alternative ◽  
Local Antibiotics ◽  
Biodegradable Implant ◽  
Bone Void Filler ◽  
Custom Made ◽  
Bone Void

The use of local antibiotics from a biodegradable implant for chronic osteomyelitis is an attractive alternative. The implant delivers high tissue levels, obliterates dead space, aids bone repair and does not need to be removed. The purpose of this paper is to review our early clinical experience with custom-made calcium sulfate (Osteoset bone void filler) antibiotic-impregnated implants.

scholarly journals Evaluation of Antibiotic-Releasing Triphasic Bone Void Filler In-Vitro

2018 ◽  
Vol 9 (4) ◽  
pp. 55 ◽  
Author(s):  
Michael Harris ◽  
Hamza Ahmed ◽  
Leslie Pace ◽  
Jon Minter ◽  
Michael Neel ◽  
...  
Keyword(s):  
Tricalcium Phosphate ◽  
Calcium Sulfate ◽  
Minimal Effect ◽  
Time Points ◽  
Dissolution Study ◽  
Infection Treatment ◽  
Bone Void Filler ◽  
Bone Void

Bone void fillers (BVFs) containing calcium sulfate, tricalcium phosphate (TCP), and hydroxyapatite can be loaded with antibiotics for infection treatment or prevention under surgeon-directed use. The aim of this study was to characterize the handling and elution properties of a triphasic BVF loaded with common antibiotics. BVF was mixed with vancomycin and/or tobramycin to form pellets, and the set time was recorded. A partial refreshment elution study was conducted with time points at 4, 8, and 24 h, as well as 2, 7, 14, 28, and 42 days. Effects on dissolution were evaluated in a 14-day dissolution study. Set time increased to over 1 h for groups containing tobramycin, although vancomycin had a minimal effect. Pellets continued to elute antibiotics throughout the 42-day elution study, suggesting efficacy for the treatment or prevention of orthopedic infections. BVF containing vancomycin or tobramycin showed similar dissolution at 14 days compared to BVF without antibiotics; however, BVF containing both antibiotics showed significantly more dissolution.

An Overview of the Percutaneous Antibiotic Delivery Technique for Osteomyelitis Treatment and a Case Study of Calcaneal Osteomyelitis

2017 ◽  
Vol 107 (6) ◽  
pp. 511-515 ◽  
Author(s):  
Jeffrey C. Karr
Keyword(s):  
Calcium Sulfate ◽  
Adjunctive Treatment ◽  
Case Presentation ◽  
Delivery Technique ◽  
Bone Void Filler ◽  
Bone Cortex ◽  
Bone Void ◽  
Carrier Vehicle ◽  
Antibiotic Delivery

Background:A percutaneous antibiotic delivery technique (PAD-T) used for the adjunctive management of osteomyelitis is presented.Methods:This surgical technique incorporates a calcium sulfate and hydroxyapatite (calcium phosphate) bone void filler acting as a carrier vehicle with either an antibiotic or an antifungal medicine, delivering this combination directly into the area of osteomyelitis.Results:The benefit of the PAD-T is reviewed with a case presentation of a successfully treated calcaneal osteomyelitis.Conclusions:No previously reported PAD-T using a simple bone cortex incision in the adjunctive treatment of osteomyelitis has been reported. The PAD-T safely and effectively uses a calcium sulfate and hydroxyapatite bone void filler carrier vehicle to deliver either an antibiotic or an antifungal medicine directly into the area of osteomyelitis.

scholarly journals In Vitro Efficacy of Antibiotics Released from Calcium Sulfate Bone Void Filler Beads

Materials ◽  
2018 ◽  
Vol 11 (11) ◽  
pp. 2265 ◽  
Author(s):  
Phillip Laycock ◽  
John Cooper ◽  
Robert Howlin ◽  
Craig Delury ◽  
Sean Aiken ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Calcium Sulfate ◽  
Joint Infection ◽  
Diffusion Method ◽  
Zone Of Inhibition ◽  
Disk Diffusion Method ◽  
Bone Void Filler ◽  
Biofilm Bacteria ◽  
Bone Void

15 different antibiotics were individually mixed with commercially available calcium sulfate bone void filler beads. The antibiotics were: amikacin, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, colistamethate sodium, daptomycin, gentamicin, imipenem/cilastatin, meropenem, nafcillin, rifampicin, teicoplanin, tobramycin and vancomycin. The efficacy of specific released antibiotics was validated by zone of inhibition (ZOI) testing using a modified Kirby–Bauer disk diffusion method against common periprosthetic joint infection pathogens. With a subset of experiments (daptomycin, rifampin, vancomycin alone and rifampin and vancomycin in combination), we investigated how release varied over 15 days using a repeated ZOI assay. We also tested the ability of these beads to kill biofilms formed by Staphylococcus epidermidis 35984, a prolific biofilm former. The results suggested that certain antibiotics could be combined and released from calcium sulfate with retained antibacterial efficacy. The daptomycin and rifampin plus vancomycin beads showed antimicrobial efficacy for the full 15 days of testing and vancomycin in combination with rifampin prevented resistant mutants. In the biofilm killing assay, all of the antibiotic combinations showed a significant reduction in biofilm bacteria after 24 h. The exposure time was an important factor in the amount of killing, and varied among the antibiotics.

In Vitro Antimicrobial Activity of Calcium Sulfate and Hydroxyapatite (Cerament Bone Void Filler) Discs Using Heat-Sensitive and Non–Heat-sensitive Antibiotics Against Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

2011 ◽  
Vol 101 (2) ◽  
pp. 146-152 ◽  
Author(s):  
Jeffrey C. Karr ◽  
Joseph Lauretta ◽  
Georgia Keriazes
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Calcium Sulfate ◽  
Bone Void Filler ◽  
Zones Of Inhibition ◽  
Standard Set ◽  
Bone Void ◽  
Carrier Systems ◽  
Carrier Vehicle

Background: Several absorbable and nonabsorbable antibiotic carrier systems are available in the adjunctive surgical management of osteomyelitis of the foot, ankle, and lower leg. These carrier systems have significant limitations regarding which antibiotics can be successfully incorporated into the carrier vehicle. The calcium sulfate and hydroxyapatite Cerament Bone Void Filler is a biocompatible, absorbable ceramic bone void filler that can successfully deliver multiple heat-stable and heat-unstable antibiotics that have not been generally used before with antibiotic beads in treating musculoskeletal infections. Methods: Cerament Bone Void Filler discs with the antibiotics rifampin, vancomycin, tobramycin, cefazolin, cefepime hydrochloride, vancomycin-tobramycin, piperacillin-tazobactam, ceftazidime, and ticarcillin-clavulanate were tested in vitro against methicillin-resistant Staphylococcus aureus. Results: The zones of inhibition for the Cerament Bone Void Filler antibiotic discs plated against Staphylococcus aureus obtained were 33% to 222% greater than the minimum zones of inhibition breakpoints for bacteria susceptibility as defined by the standard set by the Clinical and Laboratory Standards Institute. Cerament Bone Void Filler discs with the antibiotics plated against Pseudomonas aeruginosa produced zones of inhibition of 93% to 200% greater than the minimum zones of inhibition breakpoints for bacteria susceptibility as defined by the standard set by the Clinical and Laboratory Standards Institute. Conclusions: The calcium sulfate and hydroxyapatite Cerament Bone Void Filler was an excellent carrier vehicle for multiple antibiotics creating in vitro significant zones of inhibition, thus demonstrating susceptibility against Staphylococcus aureus and Pseudomonas aeruginosa, which holds tremendous promise in treating osteomyeilits. (J Am Podiatr Med Assoc 101(2): 146–152, 2011)

Lower-Extremity Osteomyelitis Treatment Using Calcium Sulfate/Hydroxyapatite Bone Void Filler with Antibiotics

2018 ◽  
Vol 108 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Jeffrey C. Karr
Keyword(s):  
Lower Extremity ◽  
Calcium Sulfate ◽  
Effective Means ◽  
Clinical Classification ◽  
Intravenous Antibiotics ◽  
Delivery Technique ◽  
Bone Void Filler ◽  
Bone Void ◽  
Antibiotic Delivery

Background: Over a 74-month period (∼6 years), 143 lower-extremity osteomyelitis locations in 125 patients were treated with a calcium sulfate/hydroxyapatite liquid bone void filler with antibiotic(s). Methods: The osteomyelitis locations were treated with a percutaneous antibiotic delivery technique delivering intraosseous antibiotic followed by either oral or intravenous antibiotics for 4 weeks. Results: There was no recurrence of osteomyelitis in 96.15% of the treatable patients. Outcomes classified by the Cierny-Mader clinical classification are discussed as well. Conclusions: A bone void filler with antibiotic(s) using the percutaneous antibiotic delivery technique is a safe, reliable, and effective means to treat lower-extremity osteomyelitis with either oral or intravenous antibiotics for 4 weeks.

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