title: Strontium-containing hydroxyapatite bioactive bone cement in revision hip arthroplasty.
abstract: Clinical outcome of cemented implants to revision total hip replacement (THR) is not as satisfactory as primary THR, due to the loss of bone stock and normal trabecular pattern. This study evaluated a bioactive bone cement, strontium-containing hydroxyapatite (Sr-HA) bone cement, in a goat revision hip hemi-arthroplasty model, and compared outcomes with polymethylmethacrylate (PMMA) bone cement. Nine months after operation, significantly higher bonding strength was found in the Sr-HA group (3.36+/-1.84 MPa) than in the PMMA bone cement group (1.23+/-0.73 MPa). After detached from the femoral component, the surface of PMMA bone cement mantle was shown relatively smooth, whereas the surface of the Sr-HA bioactive bone cement mantle was uneven, by SEM observation. EDX analysis detected little calcium and no phosphorus on the surface of PMMA bone cement mantle, while high content of calcium (14.03%) and phosphorus (10.37%) was found on the surface of the Sr-HA bone cement mantle. Even higher content of calcium (17.37%) and phosphorus (10.84%) were detected in the concave area. Intimate contact between Sr-HA bioactive bone cement and bone was demonstrated by histological and SEM observation. New bone bonded to the surface of Sr-HA cement and grew along its surface. However, fibrous tissue was observed between PMMA bone cement and bone. The results showed good bioactivity of Sr-HA bioactive bone cement in this revision hip replacement model using goats. This in vivo study also suggested that Sr-HA bioactive bone cement was superior to PMMA bone cement in terms of bone-bonding strength. Use of bioactive bone cement may be a possible solution overcoming problems associated with the use of PMMA bone cement in revision hip replacement.
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, and Department of Orthopaedics Surgery, The General Hospital of PLA, Beijing, China.
authors.forename: G X
authors.initials: GX
authors.lastname: Ni
authors.forename: K Y
authors.initials: KY
authors.lastname: Chiu
authors.forename: W W
authors.initials: WW
authors.lastname: Lu
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: Y G
authors.initials: YG
authors.lastname: Zhang
authors.forename: L B
authors.initials: LB
authors.lastname: Hao
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Li
authors.forename: W M
authors.initials: WM
authors.lastname: Lam
authors.forename: S B
authors.initials: SB
authors.lastname: Lu
authors.forename: K D K
authors.initials: KD
authors.lastname: Luk
mesh_terms: D000818:Animals; D019644:Arthroplasty, Replacement, Hip; D018786:Bone Substitutes; D017886:Durapatite; D006041:Goats; D006622:Hip Prosthesis; D013324:Strontium
chemical_list: D018786:Bone Substitutes; D017886:Durapatite; D013324:Strontium