Biomedical Engineering Reference
In-Depth Information
TM
is indicated for the
repair of neurosurgical burr holes, contiguous craniotomy cuts
and other cranial defects with a surface area no larger than 25
cm
standpoint [202]. For example, BoneSource
2
per a defect. In addition, it may be used in the sinus region for
facial augmentation [103, 490] and the cement can be supported
by metal hardware [103]. In dogs, BoneSource
TM
was employed
to supplement the supraorbital ridge and to augment skull base
defects [491]. Another group performed trials to ascertain the
inflammation around the site and the degree of loss of the implanted
BoneSource
TM
. The material was found to be osteoconductive with
both periosteal and endosteal bone formation [492]. One more
group presented excellent results using the material combined with
an underlying resorbable mesh in calvarian defects of Yorkshire
pigs. They found progressive bone ingrowths in all defects at 180
days, with nearly complete replacement by host bone [325]. Besides,
excellent results for over 100 human patients were reported when
a calcium orthophosphate cement was used in cranial defects. The
success rate of the cement after 6 years was 97% [94]. The results of
still other medical trials are available elsewhere [220, 493-505]. To
conclude this part, one should stress that complications still occur:
namely, two cases of apatite bone cement resorption and subsequent
seroma formation have been recently reported for patients who had
undergone retrosigmoid craniotomy [506].
5.8.3
Orthopedic Applications
Self-setting calcium orthophosphate formulations have successfully
been used for treatment of the distal radius fracture [206, 507, 508].
Besides, other successful attempts have been made to use these
formulations for calcaneal fractures [509], hip fractures [510, 511],
augmentation of osteoporotic vertebral bodies [512], distal radius
fractures [513], tibial plateau fractures [33, 513-517], restoration of
pedicle screw fixation [518, 519], reinforcement of thoracolumbar
burst fractures [520], cancellous bone screws [521, 522], in wrist
arthrodesis [523] and for fixation of titanium implants [524]. A recent
study on a cement augmentation of the femoral neck defect might
be found elsewhere [525]. Considering their properties, calcium
orthophosphate cements might potentially be applied to reinforce
osteoporotic vertebral bodies [512, 526]. Further details on this topic
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