Macroporous calcium phosphate ceramic for long bone surgery in humans and dogs. Clinical and histological study

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Abstract
Our previous studies reported the performance of Macroporous Biphasic Calcium Phosphate (MBCP) in spine fusion. In the present study, this material was used in block forms in selected patients with tumoral resection in long bone. Two cases were chosen with large benign bone tumors. Clinical and radiographic assessments, CT scans, and NMR were performed after 16 months, and in one case control biopsies were taken. In order to understand the kinetic process of biodegradation of the MBCP blocks and bone formation at the expense of the ceramics, an experimental study in surgicaly created bond defects in canine femoral cortices was made. The MBCP blocks recovered after implantation period from 2 to 18 weeks were analyzed using histological, stereological, ultrastructural, electron microprobe, and IR spectroscopy analyses. This study demonstrated the efficiency of MBCP blocks for filling pathological defects in human long bone. The biointegration process of the MBCP blocks was due to a partial dissolution of the ceramics crystals (b-TCP content) by multinucleated cells. Simultaneously, bone ingrowth at the expense of the ceramic is observed. The new bone formation inside the MBCP macropores and in the spaces between the blocks, involved the formation of a new cortical bone on the outer part, and a trabecularlike bone with bone marrow in the inner part of the implant. The biological resorption of the MBCP ceramic decreased after 1 month implantation in dog, due to the protective role of the newly formed lamellar bone on the surface and in the core of the ceramics.