Effects of a magnesium adhesive cement on bone stability and healing following a metatarsal osteotomy in horses

Abstract

Objective - To compare biodegradable magnesium phosphate cement (Mg-cement), calcium phosphate cement (Ca-cement), and no cement on bone repair, biocompatibility, and bone adhesive characteristics in vivo in horses. Animals - 8 clinically normal adult horses. Procedures - Triangular fragments (1-cm-long arms) were created by Y-shaped osteotomy of the second and fourth metatarsal bones (MTII and MTIV, respectively). Fragments were replaced in pairs to compare Mg-cement (MTII, n = 8; MTIV, 8) with Ca-cement (MTIV, 8) or with no cement (MTII, 8). Clinical and radiographic evaluations were performed for 7 weeks, at which time osteotomy sites were harvested for computed tomographic measurement of bone density and callus amount, 3-point mechanical testing, and histologic evaluation of healing pattern and biodegradation. Results - All horses tolerated the procedure without clinical problems. Radiographically, Mg-cement secured fragments significantly closer to parent bone, compared with Ca-cement or no treatment. Callus amount and bone remodeling and healing were significantly greater with Mg-cement, compared with Ca-cement or no cement. Biomechanical testing results and callus density among treatments were not significantly different. Significantly greater woven bone was observed adjacent to the Mg-cement without foreign body reaction, compared with Ca-cement or no cement. The Mg-cement was not fully degraded and was still adhered to the fragment. Conclusions and clinical relevance - Both bone cements were biocompatible in horses, and Mg-cement may assist fracture repair by osteogenesis and fragment stabilization. Further studies are warranted on other applications and to define degradation characteristics.