Do porous calcium hydroxyapatite ceramics cause porosis in bone? A bone densitometry and biomechanical study on cortical bones of rabbits.

Porous calcium hydroxyapatite (CHA) ceramics are biocompatible and present osteoconductive properties. These ceramics are widely used in orthopaedic surgery; however, it is not yet known whether they have some adverse effects on bone and bone marrow healing. Our previous radiological study revealed possible local porosis at the adjacent sites of the CHA ceramic. Histological findings of the same study revealed bone marrow swelling and depletion at the implantation site. Osteoclasts removed particles of the implant that may be the cause of local porosis. In the present study, possible local osteoporosis was evaluated by bone densitometry analyses, and compression and three-point bending tests. CHA particles were implanted into the left limbs and a sham operation was utilized on the right limbs of 75 white rabbits. The animals were followed up for 23 weeks for bone mineral density and for 6 months for biomechanical analyses. The CHA implanted area and its distal or proximal adjacent areas were evaluated with a Hologic QDR-2000 bone densitometer. Three-point bending and compression tests were performed with an M-30 K material testing device. The results revealed a time-dependent bone density increase at the CHA implantation site and no significant porosis at adjacent areas of the implant. The stiffness of CHA-implanted bones in three-point bending is larger than that of the control group. CHA-implanted rabbit bones presented a different fracture pattern from the control group. The stiffness of the control and CHA-implanted bones generally increased with time indicating no adverse effects of porous CHA ceramics in bone and bone marrow healing. The clinical relevance of this work is that porous CHA ceramics do not cause local porosis at adjacent areas when implanted into osseous sites.(ABSTRACT TRUNCATED AT 250 WORDS)