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J Knee Surg
DOI: 10.1055/a-2410-2552
Original Article

Comparing the Rate of Dissolution of Two Commercially Available Synthetic Bone Graft Substitutes

Kara McConaghy 
1   School of Medicine, Case Western Reserve University, Cleveland, Ohio
,
Michael Smietana
2   Stryker Corporation, Kalamazoo, Michigan
,
Ignacio Pasqualini 
3   Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Pedro J. Rullán 
3   Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Jesse Fleming
2   Stryker Corporation, Kalamazoo, Michigan
,
Nicolas S. Piuzzi 
3   Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
4   Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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Abstract

This study characterized the dissolution properties of two commercially available bone substitutes: (1) A calcium sulfate (CaS)/brushite/β-tricalcium phosphate (TCP) graft containing 75% CaS and 25% calcium phosphate; and (2) a CaS/hydroxyapatite (HA) bone graft substitute composed of 60% CaS and 40% HA. Graft material was cast into pellets (4.8 mm outer diameter × 3.2 mm). Each pellet was placed into a fritted thimble and weighed before being placed into 200 mL of deionized water. The pellets were removed from the water on days 1, 2, 3, 4, 6, 8, 14, 18, or until no longer visible. The mass and volume of each pellet were calculated at each timepoint to determine the rate of dissolution. Analysis of variance was performed on all data. Statistical significance was defined as p < 0.05. The CaS/HA pellets were completely dissolved after day 8, while the CaS/brushite/β-TCP pellets remained until day 18. The CaS/brushite/β-TCP pellets had significantly more mass and volume at days 1, 2, 3, 4, 6, and 8 timepoints. The CaS/brushite/β-TCP pellets lost 46% less mass and 53% less volume over the first 4 days as compared to CaS/HA pellets. The CaS/brushite/β-TCP pellets had a rough, porous texture, while the CaS/HA pellets had a smooth outer surface. Overall the CaS/brushite/β-TCP pellets dissolved approximately twice as slowly as the CaS/HA pellets in vitro. As these in vitro findings might have in vivo implications, further clinical data are required to further confirm and establish the optimal synthetic bone substitute strategy or antibiotic delivery carrier.

Keywords

bone graft substitute - dissolution - resorption

Authors' Contributions

K.M.: interpretation of data, drafting the paper and revising it critically, approval of the submitted and final versions


M.S.: research design, acquisition, analysis and interpretation of data, approval of the submitted and final versions


I.P.: interpretation of data, drafting the paper and revising it critically, approval of the submitted and final versions


P.J.R.: interpretation of data, drafting the paper and revising it critically, approval of the submitted and final versions


J.F.: research design, acquisition, analysis, and interpretation of data, approval of the submitted and final versions


N.S.P.: research design, critical manuscript revisions, supervision, approval of the submitted and final versions


All authors have read and approved the final submitted manuscript.




Publication History

Received: 12 May 2023

Accepted: 04 September 2024

Accepted Manuscript online:
05 September 2024

Article published online:
11 October 2024

© 2024. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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