Artificial Bones

Julio Correa

How bones work

Bone is a composite material, consisting of crystals of mineral bound
to protein.
This provides both strength and resilience so that the skeleton can
absorb impact without breaking.
A structure made only of mineral would be more brittle and break
more easily, while a structure made only of protein would be soft and
bend too easily.
The mineral phase of bone consists of small crystals containing
calcium and phosphate, called hydroxyapatite.

 Cortical bone accounts for 80% of the mass of

bone in the human body, it has a much lower
surface area than cancellous bone due to its
lower porosity.
Cancellous (or trabecular) bone is located at the
ends of long bones, accounts for roughly 20% of
the total mass of the skeleton.

Formation and remodeling of bone

Osteoblasts
Bone-forming cells found near the surface of bones.
Osteocytes
Their main role is homeostasis maintaining the correct oxygen and
mineral levels in the bone.
Osteoclasts
Responsible for bone resorption.

Important functions
Bone is a dynamic, highly vascularized tissue with the unique capacity
to heal and remodel without leaving a scar .
Provide mechanical stability to the skeleton that is needed for load
bearing, locomotion and protection of internal organs.
Bone serves as a mineral reservoir and has the capacity to rapidly
mobilize mineral stores if needed for homeostasis of the calcium
blood level.

 Due to the ageing world population, techniques to replace, restore, or

regenerate bone have become a major clinical need in the fields of
orthopedic, spinal, dental, cranial, and maxillofacial surgery.
Genetic abnormalities can produce weak, thin bones, or bones that are too
dense.
Nutritional deficiencies, particularly of vitamin D, calcium, and phosphorus,
can result in the formation of weak, poorly mineralized bone.
Abnormalities in remodeling are the primary cause of bone disease.

These bits of disconnected bone may be measured as bone mass,

but contribute nothing to bone strength.

Bone replacement
Bone replacement materials can be needed for a variety of reasons.
They are sometimes required when a section of bone is missing and
the gap needs to be filled in, for example following an accident or
after the removal of a tumor.
Allografts / Xenografts
Autografts
Artificial bone (Synthetic materials)
DBM (Demineralized Bone Matrix)
Ceramics

Autografts
Autografts have the advantages of no adverse immunological
response.
Their availability is qualitatively limited by the anatomy and
physiological conditions of the donor site.
They have no mechanical strength and shape which can precisely
duplicate the bone being replaced.

Allografts
Allograft bone can either be collected from cadavers or living donors.
Available in considerable quantity, can be strong mechanically.
Inherent risk of disease transmission and immune reactions.

With such critical arguments on applications of naturally derived bone

grafts, development of artificial bone substitution materials made
from metals, ceramics, polymers, and composites are of a great
importance.

Bone graft fills in space between two vertebrae after disc

has
been removed

 Ideal artificial bone- Biocompatible.

Applications
Artificial bones are useful for tissue augmentation in patients with
facial deformities or defects. Custom-made artificial bones, produced
by mirroring the bone structure on the healthy side using computeraided design, have been used.

 3D simulation models with special wax

The artificial jaw was made from titanium powder, heated

and built-up in layers in a 3D printer to create a working
lower jaw which was then finished with a bioceramic
coating.

Bone Metastases in
the Upper Extremity

The humerus has been stabilized with an intramedullary

rod inserted down the center of the bone.

Artificial replacement of the upper arm bone.

Segmental spacer replacing a portion of the humerus

bone.

 Clinical application of CHACC used for bone augmentation after skeletal tumour resection.
Before surgery, the tumour had invaded deep into the bone cavity and occupied nearly half the length of the
humerus
With CHACC (Coralline hydroxyapatite/calcium carbonate) implantation, two years and seven months after
surgery, the bone was completely healed, with normal function.

 Stapedectomy (stapes is replaced with a small plastic tube

surrounding a short length of stainless steel wire)

Due to Otosclerosis (Abnormal, microscopic growth of

bone in the walls of the inner ear which causes the stapes bone to
become frozen in place or fixed)

B.D. Ratner, A.S. Hoffman, Biomaterials Science: An Introduction to Materials in Medicine,

Elsevier Science & Technology, 2004.

Handbook of Porous Solids, Wiley-VCH, Weinheim, 2002, 2923pp.

L.L. Hench, Biomaterials 19 (1998).

Otosclerosis | University of Maryland Medical

Center http://umm.edu/programs/hearing/services/otosclerosi
s#ixzz3ohXkadFs
University of Maryland Medical Center