DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?

F Allen; G Blunn; ID McCarthy; M O'Donnell; MM Stevens; AE Goodship

doi:10.1302/1358-992X.94BSUPP_XXXVI.BORS2011-015

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DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?

British Orthopaedic Research Society (BORS)

F Allen
G Blunn
ID McCarthy
M O'Donnell
MM Stevens
AE Goodship

DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?

Allen F, Blunn G, McCarthy I, O'Donnell M, Stevens M, Goodship A. DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?. Orthop Procs. 2012;94-B(SUPP_XXXVI):15-15. doi:10.1302/1358-992X.94BSUPP_XXXVI.BORS2011-015

Allen, F, et al. “DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?.” Orthopaedic Proceedings, vol. 94-B, no. SUPP_XXXVI, 2012, pp. 15-15., https://doi.org/10.1302/1358-992X.94BSUPP_XXXVI.BORS2011-015

Allen, F., Blunn, G., McCarthy, I., O'Donnell, M., Stevens, M., & Goodship, A. (2012). DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?. Orthopaedic Proceedings, 94-B(SUPP_XXXVI), 15-15. https://doi.org/10.1302/1358-992X.94BSUPP_XXXVI.BORS2011-015

Allen, F., Blunn, G., McCarthy, I., O'Donnell, M., Stevens, M. and Goodship, A. (2012) “DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?.” Orthopaedic Proceedings, 94-B(SUPP_XXXVI), pp. 15-15. Available at: https://doi.org/10.1302/1358-992X.94BSUPP_XXXVI.BORS2011-015

Allen, F, G Blunn, ID McCarthy, M O'Donnell, MM Stevens, and AE Goodship. “DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?.” Orthopaedic Proceedings 94-B, no. SUPP_XXXVI (2012): 15-15. https://doi.org/10.1302/1358-992X.94BSUPP_XXXVI.BORS2011-015

Allen F, Blunn G, McCarthy I, O'Donnell M, Stevens M, Goodship A. DOES A STRONTIUM SUBSTITUTED BIOGLASS ENHANCE THE RATE OF BONE INGROWTH INTO A CRITICAL SIZE DEFECT COMPARED TO A COMMERCIALLY AVAILABLE TCP-CASO4?. Orthop Procs. 2012 Aug 1;94-B(SUPP_XXXVI):15-15. https://doi.org/10.1302/1358-992X.94BSUPP_XXXVI.BORS2011-015

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Abstract

Synthetic bone grafts are used in several major dental and orthopaedic procedures. Strontium, in the form of strontium ranelate, has been shown to reduce fracture risk when used to treat osteoporosis. The aim of the study was to compare bone repair in femoral condyle defects filled with either a 10% strontium substituted bioactive glass (StronBoneTM) or a TCP-CaSO4 graft. We hypothesise that strontium substituted bioactive glass increases the rate of bone ingrowth into a bone defect when compared to a TCP-CaSO4 ceramic graft.

A critical size defect was created in the medial femoral condyle of 24 sheep; half were treated with a Sr-bioactive glass (StronBoneTM), and in the other animals defects were filled TCP-CaSO4. Two time points of 90 and 180 days were selected. The samples were examined with regard to: bone mineral density (BMD) from peripheral quantitative CT (pQCT), mechanical properties through indentation testing, and bony ingrowth and graft resorption through histomorphometry.

The radiological density of Sr-bioactive glass in the defect is significantly higher than that of the TCP-CaSO4-filled defect at 90 and 180 days, (p=0.035 and p=0.000). At 90 days, the stiffness of the defect containing Sr-bioactive glass and is higher than that of the TCP-CaSO4 filled defect, (p=0.023). At 6 months there is no significant difference between the two materials. Histomorphometry showed no significant difference in bone ingrowth at any time point, however significantly more of the graft is retained for the StronBoneTM treatment group than the TCP-CaSO4 group at both 0 days (p=0.004) and 180 days (p=0.000). The amount of soft tissue within the defect was significantly less in the StronBoneTM group than for the TCP-CaSO4 group at 90 days (p=0.006) and 180 days (p=0.000)

The data shows the mechanical stability of the defect site is regained at a faster rate with the strontium substituted bioglass than the TCP-CaSO4 alternative. Histomorphmetry shows this is not due to increased bone ingrowth but may be due to the incorporation of stiff graft particles into the trabeculae. Sr-bioactive glass produces a stronger repair of a femoral condyle defect at 3 months compared with TCP-CaSO4.