Long-term bone response to particulate injectable ceramic

Biphasic calcium phosphate particles (BCP), alone or combined with a cellulosic ether vehicle in an injectable composite material (COMP), were implanted in femurs of rabbits. The long-term follow-up (up to 78 weeks) indicated: (1) BCP and COMP induced a foreign-body inflammatory reaction but without fibrous encapsulation. Phagocytosis was mediated by mononucleated macrophages (MC) and giant multinucleated cells (GMNC). Phagocytosis was stronger with COMP and required the recruitment of GMNC while it primarily involved MC in the case of BCP. (2) There appeared to be no significant difference between the bone ingrowth in the defects packed with BCP (dBCP) and in those filled with COMP (dCOMP). Bone reconstruction mostly was achieved after 4 weeks in dBCP but took more time to reach the center of dCOMP. High bone remodeling was observed at the last evaluation times, especially in the case of COMP. (3) Degradation of the materials occurred mainly during the first 4 weeks and was more severe for COMP, which probably was related to the smaller granulometry of its mineral phase. Cell-mediated degradation went on for the 78 weeks and followed two processes: phagocytosis and/or extracellular dissolution of the calcium phosphate particles.