Development, characterization, and validation of porous carbonated hydroxyapatite bone cement

Carbonated hydroxyapatite (CHA) bone cement is capable of self-setting and forming structures similar to mineralized bone. Conventional CHA leaves little room for new bone formation and delays remodeling. The purposes of this study were to develop porous CHA (PCHA) bone cement and to investigate its physicochemical properties, biocompatibility, biodegradation, and in vivo bone repair potential. Vesicants were added to modify CHA, and the solidification time, porosity, and pore size of the PCHA cements were examined. The cytotoxicity and bone repair potential of PCHA were tested in a rabbit bone defect model and assessed by x-ray, histological examination, and mechanical testing. The porosity of the modified PCHA was 36%; 90.23% of the pores were greater than 70 mum, with a calcium/phosphate ratio of 1.64 and a solidification time of 15 minutes. The PCHA did not affect bone cell growth in vitro, and the degrading time of the PCHA was two and four times faster in vitro and in vivo when compared to CHA. In the bone defect model, the amount of new bone formation in the PCHA-treated group was eight times greater than that of the CHA group; the compressive strength of the PCHA setting was relatively weak in the first weeks but increased significantly at 8 to 16 weeks compared to the CHA group. The PCHA has stable physicochemical properties and excellent biocompatibility; it degrades faster than CHA, provides more porous spaces for new bone ingrowths, and may be a new form of bone cement for the management of bone defects.