Cranial flap fixation in sheep using a resorbable bone adhesive

Area of Science:

• Biomaterials Science
• Orthopedic Surgery
• Regenerative Medicine

Background:

• Cranial bone flap fixation traditionally uses titanium plates and screws.
• These methods can lead to complications like hardware migration and infection.
• Novel bioresorbable materials are being explored to improve fixation and healing.

Purpose of the Study:

• To investigate the efficacy and safety of a novel tetracalcium phosphate and phosphoserine (TTCP-PS) bone adhesive for cranial bone flap fixation.
• To compare the performance of TTCP-PS with conventional titanium plates and screws in an ovine model.

Main Methods:

• An ovine craniotomy model was used with 41 sheep.
• Cranial defects were filled with TTCP-PS (fully or partially) or left empty with plate/screw fixation (control).
• Evaluations included macroscopic, histopathological, histomorphometric, and biomechanical analyses over 2 years.

Main Results:

• TTCP-PS demonstrated no adverse local tissue effects.
• Fixation strength was significantly greater in TTCP-PS groups compared to controls at 12 weeks and 1 year.
• Histomorphometric analysis and biomechanical testing indicated superior performance and osteointegration with TTCP-PS, particularly in the fully filled group.

Conclusions:

• TTCP-PS is a safe and effective bioresorbable adhesive for cranial flap fixation.
• It offers biomechanical advantages, promotes faster bone healing without fibrosis, and reduces hardware-related complications.
• TTCP-PS shows potential to enhance human cranial bone flap fixation and cranioplasty procedures.