Assessment of resorbable bioactive material for grafting of critical-size cancellous defects.

Bioactive glasses form a surface apatite layer in vivo that enhances the formation and attachment of bone. Sol-gel Bioglass graft material provides greater nanoscale porosity than bioactive glass (on the order of 50-200 A), greater particle surface area, and improved resorbability, while maintaining bioactivity. This study histologically and biomechanically evaluated, in a rabbit model, bone formed within critical-sized distal femoral cancellous bone defects filled with 45S5 Bioglass particulates, 77S sol-gel Bioglass, or 58S sol-gel Bioglass and compared the bone in these defects with normal, intact, untreated cancellous bone and with unfilled defects at 4, 8, and 12 weeks. All grafted defects had more bone within the area than did unfilled controls (p < 0.05). The percentage of bone within the defect was significantly greater for the 45S5 material than for the 58S or 77S material at 4 and 8 weeks (p < 0.05), yet by 12 weeks equivalent amounts of bone were observed for all materials. By 12 weeks, all grafted defects were equivalent to the normal untreated bone. The resorption of 77S and 58S particles was significantly greater than that of 45S5 particles (p < 0.05). Mechanically, the grafted defects had compressive stiffness equivalent to that of normal bone at 4 and 8 weeks. At 12 weeks, 45S5-grafted defects had significantly greater stiffness (p < 0.05). At 8 and 12 weeks, all grafted defects had significantly greater stiffness than unfilled control defects (p < 0.05). In general, the 45S5-filled defects exhibited greater early bone ingrowth than did those filled with 58S or 77S. However, by 12 weeks, the bone ingrowth in each defect was equivalent to each other and to normal bone. The 58S and 77S materials resorbed faster than the 45S5 materials. Mechanically, the compressive characteristics of all grafted defects were equivalent or greater than those of normal bone at all time points.

Effect of bioactive glass particle size on osseous regeneration of cancellous defects.

The bioactive glass known as Bioglass or Perioglass (USB) (US Biomaterials, Alachua, FL) has proven to be an effective graft material owing to the apatite layer which forms on the surface of the glass, promoting bone formation. USB particles range in size from 90 to 710 microns in diameter, as determined by optical microscopy. A similar bioactive material, BioGran (OV) (Orthovita, Malvern, PA), was developed to limit the particle size of 4555 to the range between 300 and 360 microns, as determined by sieving. The objective of this study was to histologically and biomechanically compare the 4555 bioactive glass, produced by US Biomaterials, in a wide particle range (USB) to the narrower particle range glass produced by Orthovita (OV) The grafted defects will then be compared to normal cancellous bone (NORM) of the distal femur in rabbits. Histologically, more bone was quantified at both 4 and 12 weeks within the defects filled with USB and NORM when compared to the limbs filled with OV (p < 0.05). The OV particles had greater particle axes and larger particle areas on average than the USB particles (p < 0.05). However, the particle axis and area of the two materials decreased with time at a similar rate. Biomechanically, the USB- and OV-grafted defects had comparable peak compressive load, compressive stiffness, and compressive modulus which were equivalent to normal bone.

Evaluation of mini-dose heparin administration as a prophylaxis against postoperative pulmonary embolism: a prospective double-blind study.

A prospective double-blind study was instituted in a group of 150 general surgical patients to test the effectiveness of mini-dose heparinization in the pre- and postoperative periods. There was a 21 per cent reduction in the incidence of deep venous thrombosis in the heparin treated group. A radiopharmaceutical imaging technique with 99m-technetium macroaggregated albumin was used to evaluate the deep venous system. The procedure proved to be simple, safe, and painless; however, it was difficult to differentiate venous stasis from deep venous thrombosis. A negative study was good evidence that deep venous thrombosis did not exist. An additional benefit of this procedure was that a perfusion lung study could be obtained which provided additional information regarding pulmonary embolism without injecting additional radiopharmaceutical. Again, the negative perfusion lung study provided more information.