Supervisors info:
Σταύρος Κ. Κουρκουλής, Καθηγητής, ΕΜΠ, Επιβλέπων
Νικόλαος Α. Παπαϊωάννου, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Σ. Μαστρόκαλος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
An alternative approach to the major problem of osteoarthritis, which begins to pique the interest of researchers, focuses on the pathogenesis of the subchondral bone and its interaction with the vitreous cartilage of the joint. The presence of bone marrow lesions, detectable on MRI scans, seems to be a predictive indicator of the progression of the disease. Subchondroplasty® is a relatively new surgical procedure for the treatment of these degenerative lesions, in which injectable calcium phosphate bone cement is infused into the affected area percutaneously, under fluoroscopic guidance. The existing data on indications and contraindications, technical features, postoperative rehabilitation, results, and safety of the method is described in detail. In the context of its use as a synthetic building material, we examine the characteristics of calcium phosphate bone cement, a particularly attractive biomaterial, which is shown to exhibit considerable osteoconductivity, bioabsorbability, and low toxicity. An experimental evaluation of its – disputed – mechanical resistance to in vitro compressive forces has been carried out, under conditions set up by ISO 8533 certification requirements for acrylic bone cement. As part of the experiment, the mechanical behaviour of five cylindrical calcium phosphate samples has been compared with that of five PMMA bone cement specimens; in both cases, the failure stress and the modulus of elasticity have been calculated from stress-strain curve. In conclusion, some thoughts are expressed about the effectiveness, the action mechanism, as well as the possible evolution of Subchondroplasty®.
Keywords:
Subchondroplasty, Bone Marrow Lesions, Calcium Phosphate bone Cement, Osteoarthritis
