Ceramic bone graft substitute with equine bone protein extract is comparable to allograft in terms of implant fixation A study in dogs

Background and purpose We studied whether osseo-integration and fixation of plasma-sprayed titanium implants grafted with beta-TCP granules (Ossaplast) can be improved by adding an osteogenic signal (Colloss E). The results were compared to implants grafted with fresh frozen morselized allograft with and without the Colloss E device. Methods 4 porous-coated Ti implants were placed in the proximal humeri in each of 10 dogs. All implants were surrounded by a 2.5-mm defect, which was grafted with: (A) beta-TCP, (B) beta-TCP + 20 mg Colloss E, (C) allograft, or ( D) allograft + 20 mg Colloss E. The observation time was 4 weeks. Results Mechanical testing showed that the beta-TCP group with Colloss E was twice as well fixed as the control group grafted with beta-TCP granules alone, and comparable to both allograft groups. We found that every control implant in the beta-TCP grafted group was covered by a dense fibrous membrane. No fibrous tissue was seen in the beta-TCP group augmented with Colloss. These implants were well osseointegrated, with new bone covering 10-25% of the implant surface. Both treated groups had increased graft resorption compared to their respective control groups. Colloss E had no effect on new bone formation or fibrous tissue reduction around the allografted implants. Interpretation The Colloss E device improved early osseointegration of implants grafted with beta-TCP granules and increased their mechanical implant fixation to the level of allografted implants. The experiment indicates that ceramic bone substitutes may be a viable alternative to allograft when combined with an osteogenic signal such as Colloss E.