28 1 2006 1 JOURNAL OF WUHAN UNIVERSITY OF TECHNOLOGY Vol. 28 No. 1 Jan. 2006,,, (, 430070) :,,, : ; ; : R 318. 08 : A :167124431 (2006) 0120030205 Development of Injectable Calcium Phosphate Bone Cement DA I Hong2lian, CH EN Xiao2m i ng, HUA N G Fu2long, L I S hi2pu (Biomedical Materials and Engineering Research Center, Wuhan University of Technology, Wuhan 430070, China) Abstract : The injectable calcium phosphate cement has many advantages : good biocompatibility, osteoconduction, biodegradation, easy2operability and plasticity. It was accepted by clinic in many fields such as bone restoration in non2load situs, drug or biofactor carri2 er, filling root canal, strengthening spongy bone screw and fixing fracture. The injectable calcium phosphate cement has wide application perspective in implantation, osteo2traumatology, radio2intervention, and so on. At present, the injectable calcium phosphate cement has become one main problem in the research of bone cement. The up2to2date research progress is summarized in this paper. Key words : calcium phosphate bone cement ; injectable ; recent developments 20 80,Brown (calcium phosphate cement,cpc), CPC,, CPC [1 ],,,,,,,,,, ( ),, CPC [2 ], CPC CPC, 1 CPC CPC, :2005210214. : (2004AA303B03). : (19702),,. E2mail :daihl9 @yahoo. com. cn
28 1, : 31 (hydroxyapatite, HAP),, CPC 2 2, CPC Khairoun [3 ] CPC,, CPC,, ( ) Leroux [4 ] 4 %, p H,,,,CPC 0. 5 %,, 0. 5 %,, CPC,, Goncalves [5 ] CPC, 10 %, 47 % 55 % CPC,,5 % CPC, 52 % ; 5 %, 3 % CPC,,,, CPC,, 2 CPC Ooms [6 ] 2Ca 3 ( PO 4 ) 2 CaHPO 4 2H 2 O CaCO 3 HAP Na 2 HPO 4 CPC,8 5 15,, CPC Gauthier [7 ] CPC,,, CPC,,,,, CPC, CPC Wolke [8 ] CPC CPC [9 ] CPC, CPC,, Flautre [10 ] CPC( 2Ca 3 ( PO 4 ) 2 Ca ( H 2 PO 4 ) 2 NaH 2 PO 4 ), 3,12, 28. 3 %, 24, 27. 8 %, X, 2 Daculsi [11 ], CPC,,, :4 CPC,12, CPC,,,CPC, 2 Landuyt [12 ] ( ),,
32 2006 1 CPC, CPC (0. 9 kn),, PMMA (1. 2 kn) / CPC Bai [1 ] CPC,,, PMMA [13 ], CPC, L,, 59 % 38 % CPC,, CPC, CPC Stankewich [14 ], 30 % 3,, CPC, 4 573 N, 3 093 N Gerhart [15 ] CPC,,12 CPC, CPC, PMMA Constantz [16 ] CPC, CPC,, Kopylov [17 ] CPC 40, 7 CPC X,2 Yetkinler [18 ], CPC 2, 3 CPC,,, CPC Otsuks [19 ], CPC CPC, CPC,,CPC, 2 :2 % 5 % 95 % 170 h 35 h ;0. 5 % 0. 2 % 500 h 50 % 30 % ;5 % 50 % 45 70 h ;5 % (25 mg) 50 h 570 h 7 mg 17 mg CPC, CPC,, : 1) CPC ( ) ;2), ;3), CPC, Sasaki [20 ] CPC,,,, PBS, CPC,,, CPC + (BMP) + ( GF) (BMP) (rh TGF2 ) (bf GF) ( TNF) ( PD GF),,, CPC,,, [21 ], 20 ng 60 mg rh TGF2
28 1, : 33 CPC,CPC rh TGF2,24 h 20 % rh TGF2 CPC,10 d 10 ng rh TGF2 CPC AL P 3 20 ng rh TGF CPC AL P 5, AL P,rh TGF2 Kamegal [22 ] BMP CPC,14 d,21 d Meraw [23 ], 1. 5 mm, GF ( 2TGF bf GF PD GF) CPC, GF CPC 3 GF 1 mm, CPC GF, GF, GF CPC, CPC + GF, ( ),CPC,, CPC 4 CPC CT MRI,,, CPC,,,,,, /, CPC CPC,, CPC, CPC, CPC, CPC, ( ) CPC,, CPC, [1 ] Bai B, Jazrawi L M, Kummer F J, et al. The Use of an Injectable, Biodegradable Calcium Phosphate Bone Subsitute for the Prophylactic Augmentation of Osteroporotic Vertebral Compression [J ]. Spine, 1999, 24 :1521 1526. [2 ] Daculsi G, Rohanizadeh R, Weiss P, et al. Crystal Polymer Interaction with New Injectable Bone Substitute : SEM and Hr TEM Study [J ]. J Biomed Mater Res, 2000, 50 (1) :1 7. [3 ] Khairoun I, Boltong M G, Driessens F C M, et al. Some Factors Controlling the Injectability of Calcium Phosphate Bone Ce2 ments [J ]. J Mater Sci : Mater Medic, 1998,9 :425 428. [4 ] Leroux L, Hatim Z, Freche M, et al. Effects of Various Adjuvants(Lactic Acid, Glycerol and Chitosan) on the Injectability of a Calcium Phosphate Cement [J ]. Bone, 1999, 25 (2 Supplement) : 31S 34S. [ 5 ] Goncalves S, Brouchet A, Freche M, et al. Formulation of an Injectable Calcium Phosphate Cement [J ]. Bioceramics, 2001, 13 :789 792. [ 6 ] Ooms E M, Egglezos E A, Wolke J G C, et al. Soft2tissue Response to Injectable Calcium Phosphate Cements [J ]. Biomateri2 als, 2003, 24 : 749 757. [7 ] Gauthier O, Khairoun I, Weiss P, et al. In vivo Comparison of Two Injectable Calcium Phosphate Biomaterials : Ionic Cement and Polymer2associated Particulate Ceramic [J ]. Key Engineering Materials, 2001,192 195 : 801 804. [8 ] Wolke J G C, Ooms E M, Jansen J A. In vivo Resorption Behavior of High Strength Injectable Calcium2phosphate Cement
34 2006 1 [J ]. Bioceramics, 2001, 13 : 793 796. [9 ] Dai H L, Yan Y H, Wang Y F, et al. Evaluation of Calcium Phosphate Cement as a Root Canal Sealer Filling Material [J ]. Journal of Wuhan University of Technology : Mater Sci Ed, 2001, 16 (4) :14 18. [ 10 ] Flautre B, Delecourt C, Blary M C, et al. Volume Effect on Biological Properties of a Calcium Phosphate Hydraulic Cement : Experimental Study in Sheep [J ]. Bone,1999, 25 (2 Supplement) : 35S 39S. [11 ] Gauthier O, Bouler J M, Wess P, et al. Kinetic Study of Bone Ingrowth and Ceramic Resorption Associated with Implanta2 tion Different Injectable Calcium Phosphate Substitutes [J ]. J Biomed Mater Res, 1999, 47 : 28 34. [12 ] Landuyt P V, Peter B, Beluze L, et al. Reinforcement of Osteosynthesis Screws with Brushite Cement [J ]. Bone, 1999, 25 (2) :95S 98S. [13 ] Mermelstein L E, Mclain R F, Yerby S A. Reinforcement of Thoracolumbar Burst Fractures with Calcium Phosphate Ce2 ment :A Biomechanical Study [J ]. Spine,1998,23 :664 670. [14 ] Stankewich C J, Swiontkowski M F, Tencer A F, et al. Augmentation of Femoral Neck Fracture Fiation with an Injectable Calcium2phosphate Bone Mineral Cement [J ]. J Orthop Res, 1996, 14 (5) : 786 793. [15 ] Gerhart T N, Renshaw A A, Miller R L, et al. Invo Histologic and Biomachnical Characteriazation of a Biodegradable Partic2 ulate Composite Bone Cement [J ]. J Biomed Mater Res, 1989, 23 (1) : 1 6. [16 ] Contantz B R, Ison I C, Fulmer M T, et al. Skeletal Repair by in Situ Formation of Mineral Phase of Bone[J ]. Science, 1995, 267 :1795 1803. [17 ] Kopylov P, Runnqvist K, Jonsson K, et al. Norian SRS Versus External Fixation in Redisplaced Distal Radial Fractures :A Randomized Study in 40 Patients [J ]. Acta Orthop Scand,1999, 70 : 1 5. [ 18 ] Yetkinler D N,Ladd A L, Poser R D,et al. Biomechanical Evaluation of Fixation of Intra2articular Fractures of the Distal Part of the Radius in Cadavera : Kirschner Wires Compared with Calcium2phosphate Bone Cement [J ]. J Bone Joint Surg, 1999, 81 : 391 399. [19 ] Otsuka M, Matsuda Y, Fox J L, et al. A Novel Skeletal Drug Delivery System Using Self2setting Calcium Phosphate Cement 9 : Effects of the Mixing Solution Volume on Anticancer Drug Release from Homogenous Drug2load Cement [J ]. J Pharm Sci, 1995,84 (6) :733 736. [20 ] Sasaki S, Ishii Y. Apatite Cement Containing Antibiotics : Efficacy in Treating Experimental Osteomyelitis [J ]. J Orthop Sci, 1999,4 :361 369. [21 ] Blom E J, Kleirr Nulend J, Klein C P, et al. Transforming Growth Factor Betal Incorporated During Setting in Calcium Phosphate Cement Stimulates Bone Cell Differentiation in Vitro [J ]. J Biomed Mater Res, 2000,50 (1) :67 74. [ 22 ] Kamegai A, Shimamurs N, Naitou K, et al. Bone Formation Under the Influence of Bone Morphogenetic Protein/ Self2setting Apatite Cement Composite as a Delvery System [J ]. Biomed Mater Eng, 1994, 4 (4) : 291 307. [ 23 ] Meraw S J, Reeve C M, Lohes C M, et al. Treatment of Peri2implant Defects with Combination Growth Factor Cement [J ]. J Periodontrol, 2000, 71 (1) : 8 13.