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Clinical Applications of Hydroxyapatite in Orthopedics

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Advances in Calcium Phosphate Biomaterials

Part of the book series: Springer Series in Biomaterials Science and Engineering ((SSBSE,volume 2))

Abstract

This chapter describes since 1982 the use of porous synthetic hydroxyapatite (HA) granules (0.1 to approximately 1.5 mm) interposed at the cement-bone interface to enhance bone bonding, a surgical procedure labeled interface bioactive bone cement (IBBC). HA granules were smeared on the bone surface just before cementing. Because the HA granules used in IBBC were pure polycrystalline HA, they were scarcely absorbed and their osteoconductive activity can continue indefinitely even after the onset of osteoporosis due to aging and even in conditions of extremely low pathological activity of bone. The appearance rate of radiolucent lines and osteolysis was extremely low even over 30 years when IBBC was used. Since 1986, in an attempt to fill the massive bony defect in the acetabulum at revision surgery of total hip arthroplasty, a mixture of HA granules with a size between 0.9∼1.2 mm and 3.0∼5.0 mm was placed densely and firmly into the bone defects. Bone ingrowth was measured to be over 2.5 cm in full depth and the new bone was very stable. Long-term clinical results over 26 years were excellent. On the weight-bearing area, bone ingrowth over 2.5 cm in full depth can be expected. However, on non-weight-bearing area, bone ingrowth is only 0.5 cm in depth. In large cavities after resection of bone tumors, or after removal of pathological fatty bone marrow at joint replacements, excellent stability to provide long-term strong bony support was obtained by filling HA granules firmly into the defects.

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Authors and Affiliations

  1. H. Oonishi Memorial Joint Replacement Institute, Tominaga Hospital, 1-4-48, Mintatomachi, Naniwa-ku, Osaka, 556-0017, Japan

    Hiroyuki Oonishi Jr. M.D., Hironobu Oonishi M.D., Ph.D., Ikuo Kawahara M.D. & Yoshifumi Hanaoka M.D.

  2. Department of Orthopaedic Surgery, Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Kita-ku, Osaka, 530-0012, Japan

    Hirotsugu Ohashi M.D., Ph.D.

  3. Olympus Terumo Biomaterials Corporation, Shinjuku Monolith, 3-1, Nishi-Shinjuku 2-chome, Shinjuku-ku, Tokyo, 163-0941, Japan

    Ryoko Iwata Ph.D.

  4. Department of Biomedical Engineering, Florida Institute of Technology, Melbourne, FL, 32901, USA

    Larry L. Hench Ph.D.

Authors
  1. Hiroyuki Oonishi Jr. M.D.
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  2. Hironobu Oonishi M.D., Ph.D.
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  3. Hirotsugu Ohashi M.D., Ph.D.
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  4. Ikuo Kawahara M.D.
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  5. Yoshifumi Hanaoka M.D.
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  6. Ryoko Iwata Ph.D.
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  7. Larry L. Hench Ph.D.
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Corresponding author

Correspondence to Hironobu Oonishi M.D., Ph.D. .

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Editors and Affiliations

  1. Chemistry and Forensic Science, University of Technology, Sydney, New South Wales, Australia

    Besim Ben-Nissan

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Oonishi, H. et al. (2014). Clinical Applications of Hydroxyapatite in Orthopedics. In: Ben-Nissan, B. (eds) Advances in Calcium Phosphate Biomaterials. Springer Series in Biomaterials Science and Engineering, vol 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-53980-0_2

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