Abstract: The biomaterial studied here is a composite associating a mineral phase of an intimate
nanoscale melting of hydroxyapatite and beta tri calcium phosphate and an aqueous phase
containing a synthetic polymer derived from cellulose HPMC (hydroxyl propyl methyl cellulose),
marketed under name MBCP Gel (FDA approval, Biomatlante manufacturer). The present
exploratory study aim was to study the safety of MBCP-gel, and to determine in the osseous healthy
area the performance of MBCP gel. We expected to prove bone ingrowth into the osseous cavities
created during drilling biopsy of the aseptic osteonecrosis of femoral head. The current results
obtained in the first two patients with 1 year follow up demonstrate the resorption and bone
ingrowth with trabecular bone architecture in the hole created into the femoral neck.
Abstract: To augment cement-bone bonding, hydroxyapatite (HA) granules were interposed at cement-bone
interface (IBBC technique). HA granules were smeared on the bone surface just before cementing
components. Porous HA granules of 300 to 500μm in diameter and 100 to 300μm in diameter were used
from 1986 to 1988(first generation) and 1989 to 1991(second generation), respectively. 222 hips of 151
patients in the first generation and 252 hips of 170 patients in second generation could be followed. After 16
to 21 year follow up, radiolucent line (space), less than 1mm, was observed in 4 hips(1.8%) in the first
generation and in 15 hips(6.2%) in the second generation(p<0.01). osteolysis was observed in 1 hip(0.5%)
and 6 hips (1.6%), respectively. Loosening (separation) was observed only 2 cups (0.8%) in the second
Abstract: In total hip prosthesis (THP), we have been using alumina ceramic femoral heads to reduce
polyethylene debris and the modified cementing technique, which was named “interface bioactive
bone cement (IBBC)” method to improve implant fixation. In this study, we investigated the
long-term clinical performance of THPs with an alumina ceramic head and IBBC method. From 1986
to 1988, 285 joints (215 patients) were operated on by a senior surgeon, and 265 joints (192 patients)
could be followed up. The presence of radiolucent lines, loosening, osteolysis and
ultrahigh-molecular-weight polyethylene (UHMWPE) socket wear were observed. In IBBC, a
radiolucent line appeared as a ’space’, and loosening appeared as a ’separation’ between the HA layer
and the cement. A ‘space’ appeared in 3 joints (1.4%) on the acetabulum and in 4 joints (1.8%) on the
femur, while a ‘separation’ appeared in 3 joints (1.4%) on the acetabulum. Osteolysis was noted in 1
joint (0.5%) on the acetabulum and in 2 joints (0.9%) on the femur. No revision surgery was required.
In our previous study, we reported that the thickness of the socket affected its clinical wear rate and
that the wear rate of sockets with an alumina ceramic head was 20% lower than that of sockets with a
metal head. By reducing wear debris through the use of ceramic heads, osteolysis could be reduced.
Long-term fixation of THPs to the bone has been achieved by using IBBC. Thus, the long-term
clinical results of THPs with an alumina head that were fixed using IBBC were excellent.
Abstract: Improved cement technique by interposing less than two layers of hydroxyapatite
(HA) granules between bone and bone cement at the cementing (Interface Bioactive Bone
Cement : IBBC) have been performed in total knee replacement (TKR). Results of TKRs of
the rheumatoid arthritis (RA) who used IBBC were evaluated. 54 knees of the RA could be
followed up clinically and radiologically. As a control, clinical results of TKR with
conventional cementing (Non-IBBC) were used. In IBBC cases, the appearance rate of the
radiolucent lines on the tibial components and the periprosthetic osteolysis of the tibial
components were significantly low. In IBBC, bone cement bound to HA mechanically
immediately after surgery and HA granules bound to the bone physicochemically after bone
ingrowth into the spaces around the HA granules. Thus, we believe that IBBC is a method
combining the advantage of cementless HA coating and bone cement.
Abstract: In the late 1970s, we started the clinical use of total knee prostheses (TKPs) composed of
alumina ceramic. In this study, we investigated the long-term clinical performance of ceramic TKPs.
First-generation ceramic TKPs were used between 1981 and 1985; second-generation TKPs, between
1990 and 1996 and third-generation TKPs, between 1993 and 1998. We examined the findings of
clinical radiographic observation. A total of 137 first-generation ceramic TKPs were followed up for
20–23 years after implantation. All the rates of loosening, sinking and revision were higher with
cementless fixation than with cemented fixation. In the second- and third-generation TKPs, all the
components were implanted using bone cement. In 249 joints that were followed up for 6–14 years,
neither loosening nor sinking was observed. No osteolysis was observed in any case. We compared
the wear of metal TKPs and ceramic TKPs that were retrieved after long-term use. Metal TKPs
exhibited a higher wear rate than ceramic TKPs, and they also exhibited scratched surface damages.
The lower wear rate and considerably less surface damage observed in our previous study suggest the
long-term durability and performance of ceramic TKPs.
Abstract: The goal of hip arthroplasty is to restore the patient to an active and pain free life for ever.
Unfortunately, prosthetic implants fail because of loosening, wear or infection. This study sets out
to ascertain whether or not Hydroxyapatite hip arthroplasty (HA) will produce long-lasting function
of at least ten years in unselected patients of all ages and all diagnoses.
Cemented implants used in hip arthroplasty often loosen after ten or more years of use. This is
partly mechanical but also associated with debris disease arising from plastic wear products.
Cementing techniques have been improved and the Swedish Hip Register  demonstrates that the
revision rates have been reduced with improved cementing techniques.
Revision surgery after cemented arthroplasty is difficult and may be complicated by fracture of the
Bioactive materials are being used to secure joint implants [2,3] and this paper presents the results
of a consecutive series of hip arthroplasties carried out over a total period of over 19 years using the
Furlong Hydroxyapatite Ceramic Coated hip prosthesis.[4, 5]
Abstract: In this study, we report human clinical and histological data on the use of micromacroporous
biphasic calcium phosphate wedges in combination with osteosynthesis with
adjustable screws for open tibial osteotomy. 42 patients were operated for open tibial osteotomy for
valgisation due to incipient medial gonarthrosis. The population was composed of 43 knees (25
right knees and 18 left knees) in 13 women and 29 men, with a mean age of 46 years. Radiological
follow-up at D+1, D+90 and D+360, and 12 biopsies for histology were processed after the removal
of the osteosynthesis. Consolidation was obtained in 100 % of cases (except one, because of failure
of the osteosynthesis). Regular bone ingrowth was observed on X-ray, with maintain of the
corrections at one year in 98.5 % of cases. Only 8 % of cases showed a radiolucent interface after
D+360. Histological examinations demonstrated resorption of the MBCP and large bone ingrowth.
Polarised microscopy confirmed the lamellar bone, and the X-rays and microscanner revealed well
mineralised and organised newly-formed bone.
Abstract: We studied the role of cytokines (TNF-α, IL-6,IL-1β, TGF-β) as markers of osteolysis in patients
who underwent to a hip prosthesis implantation subdivided in two groups: group A with an ultrahigh
molecular weight polyethylene (UHMWPE) insert articulating against a metal ball head , and
group B with an all alumina ceramic combination.
Profibrogenic (TGF-β) and pro-inflammatory cytokines (TNF-α, IL-6,IL-1β) are secreted by the
periprosthetic synovial-like fibrous membrane in hip artificial implants. They are secreted by
inflammatory activated cells and trigger the cascade of biochemical events leading to the activation
of osteoclasts and bone resorption.
A statistically significant increase of TGF-β serum levels was observed between TGF-β values in
implanted patients as compared to normal subjects and between TGF-β values after versus before
implantation in Group A.
A progressive decrease in TNF-α and IL-6 serum levels has been observed in both Groups, when
compared with the initial values before the implantation. IL-1β levels decreased up to 60 months
after the implantation
Our data suggest that monitoring circulating cytokines could be a good indicator for the
proliferation and activity of the periprosthetic synovial-like membrane and potential osteolysis. This
could allow for an adequate early treatment.
Abstract: The aims of this study are to confirm the capacity of hard tissue induction by human demineralized
dentin matrics (DDM) and calcified dentin matrics (CDM) in subcutaneous tissues of nude mice,
and to report a human pioneering trial following the autotransplantation of DDM for bone
augmentation in a case of the atrophied upper jaw. Human DDM and CDM particles were prepared
from adult, extracted vital teeth, and were implanted into the subcutaneous tissues of 4-week-old
nude mice. DDM induced bone and cartilage independently at 4 weeks after implantation, while
CDM did not induce a hard tissue formation. Autogenous DDM prepared from the non-functional
second molar of a 58-year-old female were grafted on the atrophied jaw and received to the host.
Human dentin can be recycled as autogenous biomaterials for local bone engineering.
Abstract: This study analyzed the examination records and radiographs of 247 patients (144 male,
103 female) who received an OSSTEM Implant (Seoul, Republic of Korea) at the dental clinic at
Chosun University, Korea, between January 2002 and December 2005. The overall success rate in
patients who received an OSSTEM Implant from surgeons of the Department of Oral Surgery at our
hospital was 93.1%, making the overall failure rate relatively low (6.9%). The failure rate for the
maxillary molar tooth was slightly higher, at 9.95%, probably as a result of its relatively lower bone
quality and reduced osteoid volume caused by pneumatization of the maxillary sinus. Thus, to
determine appropriate treatment, it is necessary to accurately determine bone quality and volume.
This can be achieved with implant placement analysis of computed tomography, precise
preoperative planning, and sufficient technical experience.