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Biokompatibilität von Polymer-Glaskeramik-Zement Cortoss®

In-vitro-Testung mit dem MG63-Zell-Modell

Biocompatibility of polymer-bioglass cement Cortoss®

In vitro test with the MG63 cell model

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Zusammenfassung

Hintergrund

Die Verankerung von Endoprothesen mit Polymethylmethacrylat(PMMA)-Zement wird seit über 50 Jahren vorgenommen und die Zementaugmentierung von Wirbelkörpern ist seit der Erstbeschreibung 1987 ein sehr häufig angewendetes Verfahren geworden. Die Zemente wurden den Anforderungen der minimal-invasiven Applikation in die Wirbelkörper angepasst, und die Kombination guter mechanischer Eigenschaften mit Biokompatibilität ist Gegenstand weiterer Entwicklungen. Unsere Studie untersucht die Eigenschaften eines Polymerzements mit Glaskeramik im Vergleich zu einem Kalziumphosphatzement.

Methode

Mit dem humanen MG63-Zellkultur-Modell wurden der Polymer-Glaskeramik-Zement Cortoss® und der Hydroxylapatitzement Kyphos® untersucht. Jeweils im Abstand von 24 h nach der ersten Inkubation wurde über 5–6 Tage das Medium in Gegenwart definierter Zementscheiben gewonnen. Dieses wurde jeweils 16 Zellkulturansätzen für jeden Zeitraum zugesetzt. Die Vitalitätsbeurteilung der Zellen erfolgte photometrisch mit dem MTT-Assay bei einer Absorption von 550 nm, die morphologische Untersuchung lichtmikroskopisch und mit dem Elektronenmikroskop.

Ergebnisse

Der Kalziumphosphatzement Kyphos® zeigt in den ersten Tagen der Zellkultur eine im Vergleich zur Kontrolle geringe Reduktion der Zellaktivität. Nach 5 Tagen war eine Angleichung an die Kontrolle erkennbar. Elektronenmikroskopisch waren nach einer Woche dreidimensionale Kristallformationen nachweisbar. In Gegenwart von Cortoss® war keine zelluläre Aktivität messbar, und die mikroskopische Untersuchung war negativ. Der zytotoxische Effekt wies zwischen den Tagen 1 und 5 nach der Zementanmischung keine Veränderung auf.

Schlussfolgerung

Der untersuchte Kalziumphosphatzement zeigt eine gute Biokompatibilität und ein Korrelat zur Apatitformation. Der Polymer-Glaskeramik-Zement weist innerhalb der ersten 5 Tage einen ausgeprägten zytotoxischen Effekt auf. Eine Erholungstendenz war in diesem Zeitraum nicht erkennbar. Polymer-Glaskeramik-Zement weist im Vergleich zu Kalziumphosphatzement eine schlechtere Biokompatibilität auf. Eine ideale Kombination physikalischer und biologischer Eigenschaften des Zements erscheint noch nicht erreicht.

Abstract

Background

Polymethylmethacrylate (PMMA) cement has been used for fixation of joint replacements for more than 50 years and cement augmentation of vertebrae has become a popular procedure since the first description in 1987. New cements have now been developed which are better suited to the requirements of minimally invasive application techniques for vertebral bodies. The combination of good mechanical properties and biocompatibility is the concern of present research. This study compared the features of a polymer-bioglass cement with a calcium phosphate cement used for vertebral augmentation.

Methods

The human osteoblast-like cell culture MG63 was used to study the polymer-glass ceramic cement Cortoss® and the hydroxyapatite cement Kyphos®. Every 24 h for 5-6 days a defined volume of the culture medium was harvested in the presence of the bone cements and added to 16 cell cultures for each time period. The viability of cells was determined photometrically at 550 nm with the MTT assay and cell morphology was studied using light and electron microscopy.

Results

In the presence of the calcium phosphate cement an early and small reduction of cell activity was found compared with the controls. At the end of 1 week the viability parameter improved nearly reaching the control level. Electron microscopy showed crystals with a 3-dimensional shape. The cell cultures with Cortoss® showed no cellular activity and the microscopic examinations were negative. This effect was not different at days 1–5 after polymerization of the cement.

Conclusions

The calcium phosphate cement studied showed a good biocompatibility and allowed morphological signs of apatite formation. At least within the first 5 days the polymer-glass ceramic cement showed a reasonable cytotoxic effect. There was no sign of recovery of cell function within that period. The biocompatibility of the polymer-glass ceramic cement appeared significantly worse compared with the calcium phosphate cement. An ideal composition of biomechanical properties and biocompatibility has not been achieved so far.

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Authors and Affiliations

  1. Klinik für Orthopädie und Rheumatologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland

    C. Fölsch

  2. Abteilung Orthopädie und Unfallchirurgie, Krankenhaus Wermelskirchen, Wermelskirchen, Deutschland

    R. Pinkernell

  3. Fachbereich Medizin, Philipps-Universität Marburg, Marburg, Deutschland

    R. Stiletto

  4. Klinik für Unfallchirurgie, Sana-Kliniken Biberach, Biberach, Deutschland

    R. Stiletto

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Correspondence to C. Fölsch.

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Fölsch, C., Pinkernell, R. & Stiletto, R. Biokompatibilität von Polymer-Glaskeramik-Zement Cortoss®. Orthopäde 42, 170–176 (2013). https://doi.org/10.1007/s00132-013-2062-8

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