Hydroxyapatite/calcium carbonate (HA/CC) vs. plaster of Paris: A histomorphometric and radiographic study in a rabbit tibial defect model

The search for an ideal bone substitute is ongoing. Multiple osteoconductive bone substitutes are available today. Plaster of Paris (POP) (calcium sulfate) has been used for more than 100 years for treatment of skeletal defects. This implant is compared to a new material, hydroxyapatite/calcium carbonate (HA/CC), in a rabbit tibia model. HA/CC is made from partial conversion of coralline calcium carbonate to hydroxyapatite and has an outer hydroxyapatite layer and an inner calcium carbonate core, a combination that leads to faster resorption than that of pure hydroxyapatite. This study compares the histomorphometric and radiographic properties of POP and HA/CC in a rabbit tibial defect. Both implants preferentially restore bone to the cortex relative to the canal. Plaster of Paris was fully resorbed by 6 weeks both radiographically and histometrically and HA/CC was substantially resorbed by 42 weeks. No significant difference was noted in volume fraction of bone between the two implants at 42 weeks postimplantation. Hydroxyapatite/calcium carbonate is a biocompatible bone graft substitute with a rate of resorption significantly slower than plaster of Paris.