Calcium phosphate bone cements

A theoretical model was developed to assess ways to improve the injectability of calcium phosphate pastes. The theoretical results were then compared to experimental data obtained on calcium phosphate slips. The theoretical approach predicted that the injectability of a cement paste could be improved by an increase of the liquid-to-powder ratio, and a decrease of the particle size and the plastic limit (PL) of the powder. The theoretical results were confirmed by experimental data. Interestingly, an increase of the viscosity of the mixing liquid with small additions of xanthan had a positive effect on the paste injectability. This effect could be due to a change of the PL of the powder or to the lubricating effect of the polymer.

In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements), and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life.