Hydroxyapatite-based biomaterial may increase peri-implant bone formation in hip fractures
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Key takeaways:
- Ceramic biomaterial remodeled into cancellous bone at 3 months postoperatively and densified at 6 months postoperatively.
- A study with a larger cohort of patients is needed to verify these results.
Published results showed application of calcium sulphate and hydroxyapatite biomaterial at the bone-implant interface may increase peri-implant bone formation in patients with osteoporosis and trochanteric fractures.
“This novel approach for fracture treatment enhances immediate and long-term fracture fixation in osteoporotic bone and could potentially reduce reoperations, morbidity and mortality,” Deepak B. Raina, PhD, associate professor and researcher in orthopedics at Lund University, told Healio.
Raina, Lars Lidgren, MD, PhD, and colleagues randomly assigned 21 patients with osteoporosis and trochanteric fractures to undergo surgery with a dynamic hip screw augmented with (n=10) or without (n=11) calcium sulphate and hydroxyapatite biomaterial at the bone-implant interface. All patients received an IV infusion of zoledronic acid mixed with normal saline after a postoperative period of 7 to 14 days.
Researchers collected radiographs and pelvic CT scans within 1 day to 3 days postoperatively, an interim CT scan at 3 months postoperatively, and radiographs, pelvic CT scans and DXA scans at 6 months postoperatively. Researchers compared bone mineral density measured by DXA scans between the two patient groups after 6 months as the primary outcome measure.
Radiographs obtained immediately after surgery showed calcium sulphate and hydroxyapatite biomaterial around the screw threads in the augmentation group, while postoperative radiographs and CT images confirmed the presence of a ceramic material around the screw head. Researchers found no adverse effects due to calcium sulphate and hydroxyapatite application prior to screw positioning, and neither the material nor radiographic contrast agent were observed in the surrounding vasculature.
Results showed the ceramic biomaterial remodeled into cancellous bone at 3 months postoperatively and densified at 6 months postoperatively. Researchers found cancellous bone formation was more prominent at the tip of the screw. Bone mineral density at the bone-implant interface in patients who received calcium sulphate and hydroxyapatite augmentation increased by 5.4% in the first region of interest, by 5.2% in the second region of interest and by 17.7% in the third region of interest compared with the control group.
However, due to small sample size, no statistical conclusions were drawn from this clinical study and these results should be verified in a larger cohort of patients, according to researchers.
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