title: Vertebroplasty using bisphosphonate-loaded calcium phosphate cement in a standardized vertebral body bone defect in an osteoporotic sheep model.
abstract: In the context of bone regeneration in an osteoporotic environment, the present study describes the development of an approach based on the use of calcium phosphate (CaP) bone substitutes that can promote new bone formation and locally deliver in situ bisphosphonate (BP) directly at the implantation site. The formulation of a CaP material has been optimized by designing an injectable apatitic cement that (i) hardens in situ despite the presence of BP and (ii) provides immediate mechanical properties adapted to clinical applications in an osteoporotic environment. We developed a large animal model for simulating lumbar vertebroplasty through a two-level lateral corpectomy on L3 and L4 vertebrae presenting a standardized osteopenic bone defect that was filled with cements. Both 2-D and 3-D analysis of microarchitectural parameters demonstrated that implantation of BP-loaded cement in such vertebral defects positively influenced the microarchitecture of the adjacent trabecular bone. This biological effect was dependent on the distance from the implant, emphasizing the in situ effect of the BP and its release from the cement. As a drug device combination, this BP-containing apatitic cement shows good promise as a local approach for the prevention of osteoporotic vertebral fractures through percutaneous vertebroplasty procedures.
authors: Université de Nantes, INSERM, UMR 791, LIOAD, Faculté de Chirurgie Dentaire, BP 84215, 44042 Nantes Cedex 1, France. Electronic address: elise.verron@univ-nantes.fr.
authors: Elise
authors: E
authors: Verron
authors: Université de Nantes, INSERM, UMR 791, LIOAD, Faculté de Chirurgie Dentaire, BP 84215, 44042 Nantes Cedex 1, France; Service d'orthopédie, Hôpital de La Pitié-Salpêtrière, 47-83, Boulevard de l'Hôpital, 75013 Paris, France.
authors: Marie-Line
authors: ML
authors: Pissonnier
authors: Université de Nantes, INSERM, UMR 791, LIOAD, Faculté de Chirurgie Dentaire, BP 84215, 44042 Nantes Cedex 1, France.
authors: Julie
authors: J
authors: Lesoeur
authors: Graftys SARL, Eiffel Park, Bâtiment D, 415 Rue Claude Nicolas Ledoux, Pôle d'Activités d'Aix en Provence, 13854 Aix en Provence Cedex 3, France.
authors: Verena
authors: V
authors: Schnitzler
authors: Université de Nantes, INSERM, UMR 791, LIOAD, Faculté de Chirurgie Dentaire, BP 84215, 44042 Nantes Cedex 1, France.
authors: Borhane Hakim
authors: BH
authors: Fellah
authors: Service d'orthopédie, Hôpital de La Pitié-Salpêtrière, 47-83, Boulevard de l'Hôpital, 75013 Paris, France.
authors: Hugues
authors: H
authors: Pascal-Moussellard
authors: Université de Nantes, INSERM, UMR 791, LIOAD, Faculté de Chirurgie Dentaire, BP 84215, 44042 Nantes Cedex 1, France.
authors: Paul
authors: P
authors: Pilet
authors: Université de Nantes, INSERM, UMR 791, LIOAD, Faculté de Chirurgie Dentaire, BP 84215, 44042 Nantes Cedex 1, France.
authors: Olivier
authors: O
authors: Gauthier
authors: Université de Nantes, INSERM, UMR 791, LIOAD, Faculté de Chirurgie Dentaire, BP 84215, 44042 Nantes Cedex 1, France.
authors: Jean-Michel
authors: JM
authors: Bouler
mesh_terms: D000818:Animals; D001843:Bone Cements / Q000494:pharmacology / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000494:pharmacology / Q000627:therapeutic use*; D004164:Diphosphonates / Q000494:pharmacology / Q000627:therapeutic use*; D004195:Disease Models, Animal; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000601:surgery* / Q000648:ultrastructure; D010024:Osteoporosis / Q000188:drug therapy* / Q000473:pathology; D010052:Ovariectomy; D019919:Prosthesis Implantation; D015203:Reproducibility of Results; D012756:Sheep; D054854:Vertebroplasty; D055114:X-Ray Microtomography
chemical_list: D001843:Bone Cements; D002130:Calcium Phosphates; D004164:Diphosphonates; C020243:calcium phosphate
keywords: Bisphosphonate; Bone augmentation; Drug-combined device; Injectable cement; Vertebral body