Reconstruction of metaphyseal fractures represents a clinical challenge for orthopedic surgeons. Especially in osteoporotic bone, these fractures are frequently accompanied by osseous substance defects. In order to ensure rapid mobilization of patients, high stability requirements must be met by osteosynthesis. Various bone graft materials have been introduced in the past, such as autologous bone or exogenous bone substitute materials. These are used as bone void fillers or as augmentation techniques to ensure safe fixation of osteosynthesis. New calcium phosphate-based bone void-filling materials could be a promising alternative to autologous bone or to the currently and widely used polymethylmethacrylate (PMMA)-based cement. The aim of this study was to evaluate a novel paste-like bone void filler in vivo and in vitro with regard to biocompatibility and osteoconductivity. In addition to in vitro testing of cell compatibility using pre-osteoblasts (MC3T3-E1), 35 Wistar rats were treated in vivo with implantation of various material mixtures based on calcium phosphate and aluminum oxide reinforcement in a metaphyseal drill hole defect. After 4 weeks, an examination by micro-computed tomography (μCT) and histology was performed. The in vitro analysis showed good biocompatibility with a high cell survival of osteoblasts. In the in vivo experiments, a significantly higher bone ingrowth compared to the empty defect was shown by μCT and histological analysis. Here, the group receiving material reinforced with aluminum oxide (Al2O3) showed a bone volume/tissue volume (BV/TV) of 89.19% compared to a BV/TV of 83.14% for the empty defect (p = 0.0013). In the group treated with a polysaccharide matrix, no increase in BV/TV was observed given a mean ratio of 80.14%. Scoring of histological sections did not reveal a significant difference between CaP and CaP that was substituted with Al2O3. The results of this study show an encouraging first step towards the development of new pasty, bone void-filling materials. We demonstrated that a new paste-like bone-filling material, based on calcium phosphate granulates and aluminum oxide to provide strength, exhibits good biocompatibility and osteoconductivity. Further biomechanical test in an osteoporotic animal model will have to be performed, to prove feasibility in metaphyseal defects.

中文翻译：

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使用包含磷酸钙和氧化铝增强材料的新型生物材料重建骨缺损。

干phy端骨折的重建代表了整形外科医生的临床挑战。特别是在骨质疏松性骨中，这些骨折经常伴有骨质缺损。为了确保患者的快速动员，必须通过骨合成满足高稳定性要求。过去已经引入了各种骨移植材料，例如自体骨或外源性骨替代材料。这些被用作骨空隙填充物或用作增强技术以确保骨固定的安全固定。新型的基于磷酸钙的骨空隙填充材料可能是自体骨或当前和广泛使用的基于聚甲基丙烯酸甲酯（PMMA）的水泥的有前途的替代品。这项研究的目的是评估一种新型的糊状骨空隙填充剂在体内和体外的生物相容性和骨传导性。除了使用成骨细胞（MC3T3-E1）进行细胞相容性的体外测试外，还对35只Wistar大鼠进行了体内治疗，方法是在干phosphate端钻孔缺损中植入基于磷酸钙和氧化铝增强材料的各种材料混合物。4周后，通过微计算机断层扫描（μCT）和组织学检查。体外分析显示出良好的生物相容性和成骨细胞的高细胞存活率。在体内实验中，通过μCT和组织学分析显示，与空缺相比，骨向内生长明显更高。这里，接受氧化铝（Al2O3）增强的材料组的骨体积/组织体积（BV / TV）为89.19％，而空缺的骨体积/组织体积为83.14％（p = 0.0013）。在以多糖基质处理的组中，在平均比率为80.14％的情况下，未观察到BV / TV的增加。组织切片的评分没有显示CaP和被Al2O3取代的CaP之间的显着差异。这项研究的结果表明，开发新型糊状，填充骨空隙的材料是令人鼓舞的第一步。我们证明了一种新的糊状骨填充材料，其基于磷酸钙颗粒和氧化铝以提供强度，表现出良好的生物相容性和骨传导性。必须在骨质疏松动物模型中进行进一步的生物力学测试，