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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 12, 1635-1640.
doi: 10.1302/0301-620X.90B12.20931  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Bone formation in a carbonate-substituted hydroxyapatite implant is inhibited by zoledronate

THE IMPORTANCE OF BIORESORPTION TO OSTEOCONDUCTION

G. Spence, MD, FRCSEd(Orth), Clinical Research Associate1; S. Phillips, MRCS, Specialist Registrar1; C. Campion, BMedSci, R&D, Project Leader2; R. Brooks, PhD, Senior Research Associate1; and N. Rushton, MD, FRCS, Director1

1 Orthopaedic Research Unit University of Cambridge, Addenbrookes Hospital, Hills Road, Cambridge CB2 2QQ, UK.
2 ApaTech Limited, 370 Centennial Park, Elstree, Hertfordshire WD6 3TJ, UK.

Correspondence should be sent to Mr G. Spence; e-mail: gmspence59{at}yahoo.co.uk

Carbonate-substituted hydroxyapatite (CHA) is more osteoconductive and more resorbable than hydroxyapatite (HA), but the underlying mode of its action is unclear. We hypothesised that increased resorption of the ceramic by osteoclasts might subsequently upregulate osteoblasts by a coupling mechanism, and sought to test this in a large animal model.

Defects were created in both the lateral femoral condyles of 12 adult sheep. Six were implanted with CHA granules bilaterally, and six with HA. Six of the animals in each group received the bisphosphonate zoledronate (0.05 mg/kg), which inhibits the function of osteoclasts, intra-operatively.

After six weeks bony ingrowth was greater in the CHA implants than in HA, but not in the animals given zoledronate. Functional osteoclasts are necessary for the enhanced osteoconduction seen in CHA compared with HA.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General