uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Injectable bone-graft substitutes: Current products, their characteristics and indications, and new developments
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
2011 (English)In: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 42, no Suppl. 2, S30-S34 p.Article in journal (Refereed) Published
Abstract [en]

More than a decade has passed since the first injectable bone substitutes were introduced for use in orthopaedic trauma, and over recent years the number of commercial products has increased dramatically. Despite the fact that these bone substitutes have been on the market for many years, knowledge amongst potential users on how and when they might be useful is still fairly limited. Most injectable bone substitutes belong to one of two major groups: by far the largest group contains products based on various calcium phosphate (CP) mixtures, whilst the smaller group consists of calcium sulphate (CS) compounds. Following mixing, the CP or CS paste can be injected into - for instance - a fracture space for augmentation as an alternative to bone graft, or around a screw for augmentation if the bone is weak. Within minutes an in situ process makes the substitute hard; the mechanical strength in compression resembles that of cancellous bone, whereas the strength in bending and shear is lower. Over time, CP products undergo remodelling through a cell-mediated process that seems to mimic the normal bone remodelling, whilst CS products are dissolved through a faster process that is not cell-mediated. For CP, a number of clinical studies have shown that it can be useful for augmentation of metaphyseal fractures when a space is present. Randomised studies have verified that CP works especially well in tibial plateau fractures when compared with conventional bone grafting. So far the number of clinical studies on CS products is very low.

Development at present seems to be heading towards premixed or directly mixed products as well as new compounds that contain fibres or other components to enhance bending and shear strength. Products that are based on combinations of CP and CS are also being developed to combine the fast-dissolving CS with the stronger and more slowly remodelling CP. Injectable bone substitutes, and especially CS, have also been targeted as potentially good carriers for antibiotics and growth factors.

Place, publisher, year, edition, pages
2011. Vol. 42, no Suppl. 2, S30-S34 p.
Keyword [en]
Injectable bone substitutes, Calcium phosphate cement, Calcium sulphate cement, Clinical indications, Fractures
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-160737DOI: 10.1016/j.injury.2011.06.013ISI: 000295213300006OAI: oai:DiVA.org:uu-160737DiVA: diva2:452773
Available from: 2011-10-31 Created: 2011-10-31 Last updated: 2011-10-31Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Larsson, Sune
By organisation
In the same journal
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 157 hits
ReferencesLink to record
Permanent link

Direct link