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. 2018 Nov;12(3):6-13.
doi: 10.5704/MOJ.1811.002.

Effect of Polymethylmethacrylate-Hydroxyapatite Composites on Callus Formation and Compressive Strength in Goat Vertebral Body

I S Komang-Agung  1 , L Hydravianto  1 , O Sindrawati  2 , P S William  3
Affiliations

Effect of Polymethylmethacrylate-Hydroxyapatite Composites on Callus Formation and Compressive Strength in Goat Vertebral Body

I S Komang-Agung et al. Malays Orthop J. 2018 Nov.

Abstract

Introduction: Percutaneous vertebroplasty (PV) is one of the available treatments for vertebral compression fracture (VCF). Polymethylmethacrylate (PMMA) is the most common bone substitute used in the procedure, but it has several disadvantages. Bioceramic material, such as hydroxyapatite (HA), has better biological activity compared to PMMA. The aim of this study was to find an optimal biomaterial compound which offers the best mechanical and biological properties to be used in PV. Materials and Methods: This was an experimental study with goat (Capra aegagrus hircus) as an animal model. The animals' vertebral columns were injected with PMMA-HA compound. Animal samples were divided into four groups, and each group received a different proportion of PMMA:HA compound. The mechanical and biological effects of the compound on the bone were then analysed. The mechanical effect was assessed by measuring the vertebral body's compressive strength. Meanwhile, the biological effect was assessed by analysing the callus formation in the vertebral body. Results: The optimal callus formation and compressive strength was observed in the group receiving PMMA:HA with a 1:2 ratio. Conclusion: A mixture of PMMA and HA increases the quality of callus formation and the material's compressive strength. The optimum ratio of PMMA:HA in the compound is 1:2.

Keywords: hydroxyapatite; polymethylmethacrylate; vertebral compression fracture; vertebroplasty.

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Figures

Fig. 1:
Fig. 1:
Histology features of the control group (100% PMMA); (a) Empty space from washed out PMMA; the host bone showing absence of callus formation or inflammatory reaction (5X, HE). (b) Remnant PMMA material along the empty space; host osteonecrosis due to heat of the cement material (20X, HE).
Fig. 2:
Fig. 2:
Histology features of group O1 (HA: PMMA ratio 1:1); (a) The space was partially filled with callus formation (20X, HE). (b) The callus embedded in the remnant of HA material (20X, HE).
Fig. 3:
Fig. 3:
Histology features of Group O2 (HA:PMMA ratio 2:1); (a) The space was entirely filled with callus formation (5X, HE). (b) The callus showed calcified trabecule, minimal remnant of HA material (20X, HE).
Fig. 4:
Fig. 4:
Histology features of Group O3 (HA:PMMA ratio 3:1); (a) The space gap was partially filled with callus formation (5X, HE). (b) A prominent remnant of HA material in fibrous callus formation (20X, HE).
See this image and copyright information in PMC

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