Augmentation materials, such as ceramic and polymeric bone cements, have been frequently used to improve the physical engagement of screws inserted into bone. While ceramic, degradable cements may ultimately improve fixation stability, reports regarding their effect on early fixation stability have been inconsistent. On the other hand, a newly developed degradable ceramic adhesive that can bond with tissues surrounding the screw, may improve the pullout performance, ensure early stability, and subsequent bony integration. The aim of this study was to investigate failure mechanisms of screw/trabecular bone constructs by comparing non-augmented screws with screws augmented with a calcium phosphate cement or an adhesive, i.e. a phosphoserine-modified calcium phosphate. Pullout tests were performed on screws inserted into trabecular cylinders extracted from human femoral bone. Continuous and stepwise pullout loading was applied with and without real-time imaging in a synchrotron radiation micro-computed tomograph, respectively. Statistical analysis that took the bone morphology into account confirmed that augmentation with the adhesive supported significantly higher pullout loads compared to cement-augmented, or non-augmented screws. However, the adhesive also allowed for a higher injection volume compared to the cement. In-situ imaging showed cracks in the vicinity of the screw threads in all groups, and detachment of the augmentation materials from the trabecular bone in the augmented specimens. Additional cracks at the periphery of the augmentation and the bone-material interfaces were only observed in the adhesive-augmented specimen, indicating a contribution of surface bonding to the pullout resistance. An adhesive that has potential for bonding with tissues, displayed superior pullout resistance, compared to a brushite cement, and may be a promising material for cementation or augmentation of implants.

增强材料，例如陶瓷和聚合物骨水泥，经常被用来改善插入骨中的螺钉的物理接合。尽管可降解的陶瓷水泥最终可以改善固色稳定性，但有关其对早期固色稳定性影响的报道却不一致。另一方面，新开发的可降解陶瓷粘合剂可以与螺钉周围的组织粘合，可以改善拔出性能，确保早期稳定性以及随后的骨整合。这项研究的目的是通过比较非增强型螺钉与增加了磷酸钙粘固剂或粘合剂（即磷酸丝氨酸修饰的磷酸钙）的螺钉来研究螺钉/小梁骨构造的失效机制。对插入从人股骨中提取的小梁圆柱体中的螺钉进行了拉拔测试。在同步加速器辐射微计算机断层扫描仪中分别进行连续成像和不实时成像的拉拔加载。考虑到骨形态的统计分析证实，与水泥增强或非增强螺钉相比，用粘合剂进行增强可支持更高的拔出载荷。但是，与水泥相比，粘合剂还允许更高的注入量。原位成像显示所有组的螺纹附近都有裂纹，并且在增强标本中增强材料与小梁骨分离。仅在粘合剂增强的样品中观察到了在增强物外围和骨-材料界面处的其他裂纹，这表明表面粘结对抗拔强度有贡献。与透钙磷石胶结剂相比，具有与组织粘结的潜力，表现出优异的抗拔出性的胶粘剂，并且可能是用于胶结或增强植入物的有前途的材料。