The bone-to-cement interface improvement by Ca-phosphate ceramics.

Background: Polymethylmethacrylate used in surgery is one of the first biomaterials. Conventional histology dissolves the resin; one of the reasons that only few complete histology is published. OBJECTIVES AND PURPOSE: The question is, whether a complete histology changes the understanding, influences the application and opens approaches for improvements. The dos and don'ts of the processing technology are presented in reproducible manner.

Material And Methods: Ten femurs of giant rabbits were taken from running experiments of femur-canal filling with bone cement. Different stages were considered for high-resolution histology and electron microscopy: 4-weeks-stage (bone healing), 12-weeks-stage (remodelling) and one and two years. A human-cadaver specimen with a follow up of two years was processed. All animals were perfusion-fixated and the complete vasculature micro-casted. Serial cuts were performed with a stone saw, followed by a wet grinding processing. The fluorescence documentation in the High Intensity Incident Fluorescent Light (HIIFL) and Orthoplan Leitz Ploemopak(®) was applied and high resolution microradiography used the Siemens Kristalloflex(®) . The Scanning Electron Microscopy (SEM) was performed applying deep-freezing technology for the PSEM-500. The human specimen was embedded after sectioning using epoxy-resin.

Results: All cement implants showed osseointegration and remodelling with a tangential adherence of bone onto the ceramic/PMMA surfaces. Intact cancellous structures after one and two years did not show any signs of heat necrosis. The human specimen confirmed the results from the animal experiments.

Conclusion: The complete bone-to-cement histology changed the understanding of the bone cements function, influenced its application and opened new ways for improvement.