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J Biomed Mater Res B Appl Biomater. 2018 Nov;106(8):2786-2795. doi: 10.1002/jbm.b.34059. Epub 2017 Dec 11.

Design and properties of a novel radiopaque injectable apatitic calcium phosphate cement, suitable for image-guided implantation.

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Graftys SA, Eiffel Park, Bâtiment D, Pôle d'activités d'Aix en Provence, 13854 Aix en Provence CEDEX 3, France.
Hôpitaux Sud - Hôpital Sainte-Marguerite, CHU APHM, 13274, Marseille Cedex 9, France.
CNRS, UPR 3079, CEMHTI, 45071, Orléans Cedex 02, France.
Université de Lorraine, CNRS, UMR 7564, LCPME, 54600, Villers-lès-Nancy, France.
Université de Nantes, CNRS, UMR 6230, CEISAM, UFR Sciences et Techniques, BP 92208, 44322, NANTES Cedex 3, France.
Guerbet, Bâtiment Rimbaud, 93420, Villepinte, France.
Université Côte d'Azur, CNRS, Inserm, iBV, UMR 7277, Tour Pasteur, UFR Médecine, 06107, Nice Cedex 02, France.


An injectable purely apatitic calcium phosphate cement (CPC) was successfully combined to a water-soluble radiopaque agent (i.e., Xenetix® ), to result in an optimized composition that was found to be as satisfactory as poly(methyl methacrylate) (PMMA) formulations used for vertebroplasty, in terms of radiopacity, texture and injectability. For that purpose, the Xenetix dosage in the cement paste was optimized by injection of the radiopaque CPC in human cadaveric vertebrae under classical PMMA vertebroplasty conditions, performed by interventional radiologists familiar with this surgical procedure. When present in the cement paste up to 70 mg I mL-1 , Xenetix did not influence the injectability, cohesion, and setting time of the resulting composite. After hardening of the material, the same observation was made regarding the microstructure, mechanical strength and alpha-tricalcium phosphate to calcium deficient apatite transformation rate. Upon implantation in bone in a small animal model (rat), the biocompatibility of the Xenetix-containing CPC was evidenced. Moreover, an almost quantitative release of the contrast agent was found to occur rapidly, on the basis of in vitro static and dynamic quantitative studies simulating in vivo implantation.


bone reconstruction; calcium phosphate; image-guided implantation; injectable cement; radiopaque agent


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