Treating damage to the muscular-skeletal organ system by means of metal implants is set to remain the ``gold standard`` of muscular-skeletal healing for the foreseeable future. However, in recent years, a paradigm shift to biologically active implants has taken place in orthopedics. There has been a move away from ``repairing`` fractures and joint damage to ``healing`` them.
Orthobiology or orthobiologics has become a synonym for the inclusion of biology and biochemistry in the development of bone replacement materials for muscular-skeletal healing. Orthobiological products, or orthobiologicals for the delivery of medicine include resorbable bone and tissue replacement materials. AAP Implantate AG is engaged in research into innovative bone replacement materials and tissue engineering. The knowledge we`ve acquired in bone replacement materials and regeneration has led to a focus on the bone mineral hydroxylapatite, which occurs naturally in the body.
PASTY NANOCRYSTALLINE HYDROXYLAPATITE IMPLANT, OSTIM® AND INJECTABLE BONE MATRIX IN PASTE FORM
Ostim® is a ready-to-use, injectable bone matrix in paste form, suitable for making good defects in fractures in the spongy area. It is a pasty nanocrystalline hydroxylapatite implant for peripheral filling or reconstructing of bone defects consisting of 100% synthetic, nanoparticular, phase free hydroxylapatite. The Ostim® syringe in the double sterile pack can be used to apply paste to the bone defect directly or by means of applicators.
It does not harden off when mixed with blood or spongiosa, so it is highly suitable for increasing the volume of autologous or homologous material. The volume stability of Ostim® 35 enables it to resist bleeding pressure. Its viscosity enables it to be applied to form-fit in close contact with the bone. Thanks to its paste-type properties, Ostim® is quickly converted into bone and new bone formation is visible after three months.
Indications
- Metaphyseal fractures and cysts
- Acetabulum reconstruction and periprosthetic fractures during hip prosthesis exchange operations
- Osteotomies
- Filling cages in spinal column surgery
- Combination with autogenous and allogenous spongiosa
- Filling in defects in children
PROPHYLAXIS CARRIER MATERIAL: PEROSSAL®
PerOssal®, a prophylaxis carrier material for the treatment of bone infections, is used for permanent filling or reconstruction of bone defects. PerOssal® makes available a bone replacement material that after surgical cleaning of the wound can be inserted into even infected bone defects with a simultaneous delivery of antibiotics, making it a good example of orthobiologics. PerOssal® is rapidly and completely absorbable. Thus the defect can be filled quickly with new, autogenous bone and the patient can be spared a further operation to remove the implant. The PerOssal® component responsible for this, a nanocrystalline hydroxylapatite, is sold by AAP Implantate AG in Germany as Ostim®.
STABLE HYDROXYLAPATITE CERAMIC ANORGANIC MATERIAL: CERABONE®
Cerabone®, a stable hydroxylapatite ceramic material with an interconnecting system of pores, is made of anorganic material. It can be supplied as a molding block in different sizes and as granules of differing dimensions. Its osteoconductive properties make it suitable as a bone replacement material for permanent filling in or reconstruction of congenital or acquired bone defects and for increasing volume in spongiosaplasty. Cerabone®`s advantages are:
- Spongiosa structure, with interconnecting macroporous and microporous pore system, is identical to that of human bone.
- Low porosity fluctuation and highly uniform spongy structure make for higher stability (pressure and shear resistance) and greater load-bearing capacity than comparable ceramics
- Optimal pore width (100–1,500 µm), whereas pore width of at least 50 µm is required for problem-free integration of implant and bone. With Cerabone®, complete bone building throughout and integration is possible
- Particularly high degree of purity of the hydroxylapatite structure
- Cerabone® molding blocks are available in larger sizes than other hydroxylapatite ceramics (up to 20x20x40 mm). So even elongated bone defects can be bridged or treated with one continuous molding block
- Easy intraoperative working (molding) of the molding block allow Cerabone® to be adjusted optimally to the particular bone defect
- Cerabone® has excellent biocompatibility
Cerabone®`s areas of application include permanent filling or reconstruction of aseptic bone defects in accident surgery and orthopedics, orthodontic and facial surgery, and plastic reconstruction.
