Ulrike Kettenberger

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SPRINGER2022

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BACKGROUND: Fracture fixation in weak bone is still a clinical challenge. Screw augmentation was shown to successfully increase their primary stability. The currently used calcium phosphate or polymeric bone cements, however, present important drawbacks such as induced toxicity and/or impaired bone neo-formation. A new approach to enhance bone screw primary stability without affecting bone formation is the use of non-setting, calcium phosphate loaded soft materials as the augmentation material. METHODS: Two types of biomaterials (non-crosslinked hyaluronic acid as viscous fluid and agar as hydrogel) were loaded with 40 wt/vol% of hydroxyapatite particles and characterized. The screw augmentation effect of all materials was evaluated through pull-out tests in bovine cancellous bone and compared to the non-augmented situation (control). The bone mineral density of each test sample was measured with μCT scans and was used to normalize the pull-out strength. FINDINGS: Both materials loaded with hydroxyapatite increased the normalized pull-out strength of the screws compared to control samples and particle-free materials. This counter-intuitive augmentation effect increased with decreasing bone mineral density and was independent from the type of the soft materials used. INTERPRETATION: We were able to demonstrate that non-setting, injectable biomaterials loaded with ceramic particles can significantly enhance the primary stability of bone screws. This material combination opens the unique possibility to achieve a screw augmentation effect without impairing or even potentially favoring the bone formation in proximity to the screw. This effect would be particularly advantageous for the treatment of osteoporotic bone fractures requiring a stabilization with bone screws.

2018

Active Agent-Particle Combination Supporting Bone Regeneration

Ulrike Kettenberger, Dominique Pioletti

The invention provides for a bioactive composition comprising solid particles, such as e.g. calcium phosphate particles, loaded with an active agent, preferably an osteoconductive/osteoinductive agent or an anti-resorptive agent like a bisphosphonate. The drug-loaded particles are included into a carrier that is preferably composed of a polymeric matrix, such as for instance a hyaluronic acid-based hydrogel. The composition is particularly useful for the treatment of bone defects, including dental-related pathological conditions, and particularly for bone regeneration/healing. The composition can be applied and/or injected directly in situ to perform its action on the bone defect. A pharmaceutical composition comprising the bioactive composition is also disclosed herein.

2017