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Tricalcium phosphate (TCP) synthetized by high temperature solid state reaction at 1400°C and three derived calcium phosphate cements (CPCs) prepared at liquid to powder (L/P) ratios of 0.33, 0.44 and 0.55 ml/g, respectively, were physicochemically characterized. Calcium deficient hydroxyapatite crystals were identified by scanning electron microscopy on CPC, and differences in crystal sizes were observed at different L/P ratios. Also, the biofilm thickness of two Staphylococcus Aureus (S.aureus) strains grown for 24 hours on the three CPC are reported. A dependence of the biofilm thickness with the specific surface area (SSA) of CPC was identified. They are directly proportional for non-extracellular polysaccharide substances (EPS) producing S.aureus and inversely proportional for EPS producing S.aureus. Non-proportional behavior between the SSA and mechanical strength of the CPC was observed as L/P ratio increases.

Breast cancer (BC) frequently metastasizes to bone, leading to poor patient prognosis. The infiltration of cancer cells in bone impairs its homeostasis, triggering a pathological interaction between tumors and resident cells. Preclinical models able to mimic the bone microenvironment are needed to advance translational findings on BC mechanisms and treatments. We designed strontium-doped calcium phosphate cement to be employed for culturing cancer and bone cells and developed an in vitro bone metastasis model. The platform was established step by step, starting with the monoculture of cancer cells, mature osteoblasts (OBs) differentiated from mesenchymal stem cells, and mature osteoclasts (OCs) differentiated from Peripheral Blood Mononuclear Cells. The model was implemented with the co-culture of cancer cells with OBs or OCs, or the co-culture of OBs and OCs, allowing us to discriminate the interaction between the actors of the bone metastatic niche. The biomimetic material was further challenged with bone metastasis patient-derived material, showing good versatility and biocompatibility, suggesting its potential use as bone substitute. Overall, we developed a bone-mimicking model able to reproduce reciprocal interactions between cancer and bone cells in a biomimetic environment suitable for studying the biomolecular determinants of bone metastasis and, in the future, as a drug efficacy platform.

Background The purpose of the present study was to compare the results of various types of anchor applications with or without augmentation in both osteopenic and severely osteoporotic bone models. Methods Two different types of suture anchors were tested in severely osteoporotic (SOP) and osteopenic polyurethane (PU) foam blocks using an established protocol. An Instron machine applied static loading parallel to the axis of insertion until failure, and the mean anchor failure strengths were calculated. The mode of failure (anchor pullout, suture tear) was recorded. The anchors tested included the Corkscrew® (CS) (Arthrex Inc., Naples, FL, USA) (without augmentation, polymethylmethacrylate (PMMA)-augmented, and bioabsorbable tricalcium phosphate (TCP) cement-augmented) and Corkscrew® FT II (CS FT II) 5.5 mm (without augmentation as used routinely). Results The mean failure loads for both SOP and osteopenic PU foam blocks, respectively, were as follows: CS, 16.2 and 212.4 N; CS with TCP, 75.2 and 396 N; CS with PMMA, 101.2 and 528.8 N; CS FT II, 13.8 and 339.8 N. Conclusions Augmentation of CS with TCP or PMMA would be essential to SOP bones. In the osteopenic bone model, although anchor fixation augmented with PMMA is the best fixation method, CS augmented with TCP cement or CS FT II without any need for augmentation may also be used as an alternative.

Tricalcium phosphate cement (α-TCP) can be used in various fields of health, including as drug delivery systems. The application of a biomaterial based on α-TCP could enable both the constant drug delivery as support and shape damaged muscleskeletics tissues until which can be regenerated by the organism itself, replacing the biomaterial, while maintaining stable levels of the drug in the organism. The aim of this study was to evaluate the release of gentamicin sulfate using the technique of electrochemical impedance spectroscopy in drug delivery systems of α-TCP. The results obtained in vitro study validated the proposed methodology for assessment of controlled drug delivery systems on the basis of α-TCP.

Kyphoplasty and vertebroplasty with polymethyl¬methacrylate (PMMA) have been used for the treatment of osteoporotic vertebral compression fractures. We performed kyphoplasty and vertebroplasty with a-tricalcium phosphate cement (CPC) and PMMA to compare the biomechanical properties. Thirty osteoporotic vertebrae were harvested from nine embalmed cadavers. We randomized the vertebrae into four treatment groups: (1) kyphoplasty with CPC; (2) kyphoplasty with PMMA; (3) vertebroplasty with CPC; and (4) vertebroplasty with PMMA. Prior to injecting the cement, all vertebrae were compressed to determine their initial strength and stiffness. They were then recompressed to determine their augmented strength and stiffness. Although the augmented strength was greater than the initial strength in all groups, there was no significant difference between the two bone cements for either kyphoplasty or vertebroplasty. The augmented stiffness was significantly less than the initial stiffness in the kyphoplasty groups, but the difference between the two cements did not reach significance. In the vertebroplasty groups, the augmented stiffness was not significantly different from the initial stiffness. There was no significant difference between the two bone cements for either procedure when cement volume and restoration of anterior height were assessed. We concluded that kyphoplasty and vertebroplasty with CPC were viable treatment alternatives to PMMA for osteoporotic vertebral compression fractures.

TB3; The bioactive α-Ca3 (PO4)2 bone cement was studied by XRD , SEM and isothermal calorimetric measurements. The results showed that a mixed pattern of TCP and hydroxylapatite were obtained after hydration and hardening. The mechanism of hydration and hardening of the α-Ca3 ( PO4 )2 was dissolution-precipitation,(NH4) H2 PO4 was the best set accelerator to the α-Ca3 ( PO4 )2 cement, and the HAP powers and the(NH4) H2 PO4 concentration had a great effect on the hydration rate of α-Ca3 ( PO4 )2.

Present surgical situations require a bone adhesive which has not yet been developed for use in clinical applications. Recently, phosphoserine modified cements (PMC) based on mixtures of o-phosphoserine (OPLS) and calcium phosphates, such as tetracalcium phosphate (TTCP) or α-tricalcium phosphate (α-TCP) as well as chelate setting magnesium phosphate cements have gained increasing popularity for their use as mineral bone adhesives. Here, we investigated new mineral-organic bone cements based on phosphoserine and magnesium phosphates or oxides, which possess excellent adhesive properties. These were analyzed by X-ray diffraction, Fourier infrared spectroscopy and electron microscopy and subjected to mechanical tests to determine the bond strength to bone after ageing at physiological conditions. The novel biomineral adhesives demonstrate excellent bond strength to bone with approximately 6.6–7.3 MPa under shear load. The adhesives are also promising due to their cohesive failure pattern and ductile character. In this context, the new adhesive cements are superior to currently prevailing bone adhesives. Future efforts on bone adhesives made from phosphoserine and Mg2+ appear to be very worthwhile.

The objective of this study is to fabricate and develop hydroxypropyl methylcellulose (HPMC) hydrogel (HG)-based composite bone cements with incorporation of hydroxyapatite (HA), beta-tricalcium phosphate (β-TCP), and with/without polymethylmethacrylate (PMMA) for vertebroplasty. For animal study, twenty female Wister rats (250–300 g, 12 weeks of age) were divided into four groups including a two non-ovariectomy (NOVX) groups and two ovariectomy (OVX)-induced osteoporosis groups. Two prepared biocomposites including HG/β-TCP/HA and HG/β-TCP/HA/PMMA were injected into the tibial defects of both OVX and NOVX rats for evaluating in vivo osteogenesis after 12 weeks. Micro-computed tomography and histological analysis using hematoxylin and eosin (H&E) and Masson's trichrome stains of the two composite cements implanted into the tibial defects of OVX and NOVX rats revealed enhanced bone regeneration potential. However, no statistically significant differences were noted among the groups based on new bone formation, demonstrating that the injected composite cements showed similar osteogenesis effects in both OVX and NOVX rats. These findings suggest that the newly developed composite bone cement composed of HG, β-TCP, HA and/or PMMA may be a promising and professional tool for treating osteoporotic and non-osteoporotic vertebral fractures.

For bone replacement materials, osteoconductive, osteoinductive, and osteogenic properties are desired. The bacterial resistance and the need for new antibacterial strategies stand among the most challenging tasks of the modern medicine. In this work, brushite cements based on powders of Zinc (Zn) (1.4 wt%) substituted tricalcium phosphate (β-TCP) and non-substituted β-TCP were prepared and investigated. Their initial and final phase composition, time of setting, morphology, pH evolution, and compressive strength are reported. After soaking for 60 days in physiological solution, the cements transformed into a mixture of brushite and hydroxyapatite. Antibacterial activity of the cements against Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa bacteria strains was attested. The absence of cytotoxicity of cements was proved for murine fibroblast NCTC L929 cells. Moreover, the cell viability on the β-TCP cement containing Zn2+ ions was 10% higher compared to the β-TCP cement without zinc. The developed cements are perspective for applications in orthopedics and traumatology.

Bacterial adhesion to the calcium phosphate surface is a serious problem in surgery. To prevent bacterial infection, the development of calcium-phosphate cements (CPCs) with bactericidal properties is indispensable. The aim of this study was to fabricate antibacterial CPCs and evaluate their biological properties. Silver-containing tricalcium phosphate (Ag-TCP) microspheres consisting of α/β-TCP phases were synthesized by an ultrasonic spray-pyrolysis technique. The powders prepared were mixed with the setting liquid to fabricate the CPCs. The resulting cements consisting of β-TCP and hydroxyapatite had a porous structure and wash-out resistance. Additionally, silver and calcium ions could be released into the culture medium from Ag-TCP cements for a long time accompanied by the dissolution of TCP. These data showed the bioresorbability of the Ag-TCP cement. In vitro antibacterial evaluation demonstrated that both released and immobilized silver suppressed the growth of bacteria and prevented bacterial adhesion to the surface of CPCs. Furthermore, histological evaluation by implantation of Ag-TCP cements into rabbit tibiae exhibited abundant bone apposition on the cement without inflammatory responses. These results showed that Ag-TCP cement has a good antibacterial property and good biocompatibility. The present Ag-TCP cements are promising for bone tissue engineering and may be used as antibacterial biomaterials.