A review of calcium phosphate cements and acrylic bone cements as injectable materials for bone repair and implant fixation

Treatment of bone defects caused by trauma or disease is a major burden on human healthcare systems. Although autologous bone grafts are considered as the gold standard, they are limited in availability and are associated with post-operative complications. Minimally invasive alternatives using injectable bone cements are currently used in certain clinical procedures, such as vertebroplasty and balloon kyphoplasty. Nevertheless, given the high incidence of fractures and pathologies that result in bone voids, there is an unmet need for injectable materials with desired properties for minimally invasive procedures. This paper provides an overview of the most common injectable bone cement materials for clinical use. The emphasis has been placed on calcium phosphate cements and acrylic bone cements, while enabling the readers to compare the opportunities and challenges for these two classes of bone cements. This paper also briefly reviews antibiotic-loaded bone cements used in bone repair and implant fixation, including their efficacy and cost for healthcare systems. A summary of the current challenges and recommendations for future directions has been brought in the concluding section of this paper.

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Therapy and regeneration-combined bone cements for minimally invasive treatment of neoplastic bone defects

Journal of Materials Chemistry B ◽

10.1039/d1tb00703c ◽

2021 ◽

Author(s):

Yu Qu ◽

Hui Zhuang ◽

Meng Zhang ◽

Yufeng Wang ◽

Dong Zhai ◽

...

Keyword(s):

Calcium Phosphate ◽

Minimally Invasive ◽

Tumor Cells ◽

Bone Tumor ◽

Tumor Resection ◽

Bone Defects ◽

Bone Cements ◽

Invasive Treatment ◽

Calcium Phosphate Cements ◽

Bone Tumor Resection

Although calcium phosphate cements (CPC) have been clinically used to repair bone defects caused by bone tumor resection, traditional CPC cannot kill the remaining tumor cells after surgery and prevent...

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Dimensional and thermal behaviour of calcium phosphate cements during setting compared to PMMA bone cements

Journal of Materials Science Letters ◽

10.1007/bf02565267 ◽

1995 ◽

Vol 14 (1) ◽

pp. 4-5 ◽

Cited By ~ 23

Author(s):

E. FernÁndez ◽

M. P. Ginebra ◽

O. Bermúdez ◽

M. G. Boltong ◽

F. C. M. Driessens ◽

...

Keyword(s):

Calcium Phosphate ◽

Thermal Behaviour ◽

Bone Cements ◽

Calcium Phosphate Cements

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Preparation, Structural Characterization, and Biomedical Applications of Gypsum-Based Nanocomposite Bone Cements

Novel Nanomaterials ◽

10.5772/intechopen.94317 ◽

2021 ◽

Author(s):

Hesham F. El-Maghraby ◽

Yaser E. Greish

Keyword(s):

Mechanical Properties ◽

Calcium Phosphate ◽

Structural Characterization ◽

Room Temperature ◽

Bone Cements ◽

Calcium Phosphate Cements ◽

Metallic Implants ◽

Hard Tissues ◽

Subsequent Conversion ◽

High Degree

Hard tissues are natural nanocomposites comprising collagen nanofibers that are interlocked with hydroxyapatite (HAp) nanocrystallites. This mechanical interlocking at the nanoscale provides the unique properties of hard tissues (bone and teeth). Upon fracture, cements are usually used for treatment of simple fractures or as an adhesive for the treatment of complicated fractures that require the use of metallic implants. Most of the commercially available bone cements are polymer-based, and lack the required bioactivity for a successful cementation. Besides calcium phosphate cements, gypsum is one of the early recognized and used biomaterials as a basi for a self-setting cementation. It is based on the controlled hydration of plaster of Paris at room temperature and its subsequent conversion to a self-setting solid gypsum product. In our work, we have taken this process further towards the development of a set of nanocomposites that have enhanced bioactivity and mechanical properties. This chapter will outline the formation, characterization, and properties of gypsum-based nanocomposites for bone cement applications. These modified cements can be formulated at room temperature and have been shown to possess a high degree of bioactivity, and are considered potential candidates for bone fracture and defect treatment.

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Nonlinear oscillatory dynamics of the hardening of calcium phosphate bone cements

RSC Advances ◽

10.1039/c7ra07395j ◽

2017 ◽

Vol 7 (64) ◽

pp. 40517-40532 ◽

Cited By ~ 6

Author(s):

Vuk Uskoković ◽

Julietta V. Rau

Keyword(s):

Phase Composition ◽

Calcium Phosphate ◽

Bone Cements ◽

Oscillatory Dynamics ◽

Calcium Phosphate Cements

Nonlinear, oscillatory dynamics was discovered in the evolution of phase composition during the setting of different calcium phosphate cements, two of which evolved toward brushite and one toward hydroxyapatite as the final product.

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Injectable calcium phosphate cement for bone repair and implant fixation

Orthopedic Clinics of North America ◽

10.1016/j.ocl.2004.06.014 ◽

2005 ◽

Vol 36 (1) ◽

pp. 89-95 ◽

Cited By ~ 63

Author(s):

John Jansen ◽

Edwin Ooms ◽

Nico Verdonschot ◽

Joop Wolke

Keyword(s):

Calcium Phosphate ◽

Calcium Phosphate Cement ◽

Bone Repair ◽

Implant Fixation

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Fast Setting Pre-Mixed Calcium Phosphate Bone Cements Based on α-Tricalcium Phosphate

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.604.204 ◽

2014 ◽

Vol 604 ◽

pp. 204-207 ◽

Cited By ~ 1

Author(s):

Zilgma Irbe ◽

Guna Krieke ◽

Kristine Salma-Ancane ◽

Liga Berzina-Cimdina

Keyword(s):

Compressive Strength ◽

Liquid Phase ◽

Calcium Phosphate ◽

Tricalcium Phosphate ◽

Aqueous Fluid ◽

Dihydrogen Phosphate ◽

Bone Cements ◽

Polypropylene Glycol ◽

Setting Reaction ◽

Calcium Phosphate Cements

Conventional calcium phosphate bone cements are self setting water based pastes. Recently pre-mixed calcium phosphate bone cements have been proposed that have non-aqueous fluid as liquid phase of the paste. Such cements thus only start setting reaction in contact with body fluids. In this work the properties (cohesion, compressive strength, phase composition) of pre-mixed calcium phosphate cements based on α-tricalcium phosphate and calcium dihydrogen phosphate monohydrate are described. Properties of several cement compositions are examined and compared to properties of β-tricalcium phosphate and calcium dihydrogen phosphate monohydrate based cements. It was found that α-tricalcium phosphate and calcium dihydrogen phosphate monohydrate based cements have higher compressive strength (10 - 15 MPa) than corresponding β-tricalcium phosphate and calcium dihydrogen phosphate monohydrate based cements (10 - 6 MPa). Out of examined cement paste liquids (glycerol, polyethylene glycol and polypropylene glycol) cements using glycerol as the liquid phase had higher compressive strength and are more cohesive.

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Bone repair in radii and tibias of rabbits with phosphorylated chitosan reinforced calcium phosphate cements

Biomaterials ◽

10.1016/s0142-9612(02)00153-9 ◽

2002 ◽

Vol 23 (21) ◽

pp. 4167-4176 ◽

Cited By ~ 91

Author(s):

Xiaohong Wang ◽

Jianbiao Ma ◽

Yinong Wang ◽

Binglin He

Keyword(s):

Calcium Phosphate ◽

Bone Repair ◽

Calcium Phosphate Cements

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Calcium Phosphate Bone Cements Reinforced with Biodegradable Polymer Fibres for Drug Delivery

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.604.184 ◽

2014 ◽

Vol 604 ◽

pp. 184-187 ◽

Cited By ~ 1

Author(s):

Zilgma Irbe ◽

Dagnija Loca ◽

Ivita Bistrova ◽

Liga Berzina-Cimdina

Keyword(s):

Compressive Strength ◽

Liquid Phase ◽

Calcium Phosphate ◽

Tricalcium Phosphate ◽

Aqueous Fluid ◽

Dihydrogen Phosphate ◽

Bone Cements ◽

Polypropylene Glycol ◽

Setting Reaction ◽

Calcium Phosphate Cements

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Calcium phosphate cements as binders for hydroxylapatite particles for bone repair

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100128614 ◽

1987 ◽

Vol 45 ◽

pp. 866-867

Author(s):

J. S. Hanker ◽

B. L. Giammara ◽

C. R. Lupton ◽

L. C. Chow

Keyword(s):

Calcium Phosphate ◽

Bone Repair ◽

Setting Time ◽

Root Canal Filling ◽

Calcium Phosphate Cements ◽

Dense Ceramic ◽

Mineral Constituent ◽

Cement Mixture ◽

Dental Applications ◽

Calcium Sulfate Hemihydrate

Calcium phosphate cements (CPCs) are under study for dental applications such as root canal filling or sealing and pulp capping. Upon setting they are converted principally to hydroxyapatite, the mineral constituent of bone. The presence of a small amount of fluoride or hydroxyapatite in the cement mixture hastens the setting time. Nevertheless, the CPCs set much more slowly than plaster of Paris (calcium sulfate hemihydrate) when moistened with water or dilute phosphoric acid.Hydroxylapatite (HA) is hydroxyapatite which has been processed either by sintering or firing into a dense ceramic or made into porous particles. Plaster has been found very useful as a binder to prevent the scatter of HA particles implanted for jawbone reconstruction. The composite HA/plaster implants can be tailored to fit the site during surgery or preformed and sterilized prior to surgery.

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