Terveydenhuollon ammattilaisille

Endobon®

Endobon® is a natural, osteoconductive hydroxyapatite ceramic which is particularly suitable for the use as bone graft substitute.

The newly built bone can grow directly on to the ceramic surface. The interconnecting pore system of Endobon® allows the new bone to grow through the whole implant leading to a stable osseous integration into natural bone.

Endobon® is used for clinical applications for more than 10 years. It is well established as a bone substitute material for metaphyseal compression fractures. Especially for traumatic fractures the easy and uncomplicated use of Endobon® is beneficial. Besides reducing the operation time and anaesthesia time the potential risks of taking autologous cancellous bone graft can be avoided.
 
 

 Features

  • osteoconductive hydroxyapatite
  • interconnecting pore system
  • pore size 100-1,500 µm
  • fully deproteinated
  • highly biocompatible
  • well documented clinical long-term results
  • augmentation with autologous bone graft, bone marrow aspirate, blood or PRP (GPS™ System)
  • several forms (blocks, cylinders) and different granules available

The Material

Endobon® is manufactured in a two-stage high-temperature process:
   1. pyrolysis at a temperature above 900 °C
   2. sintering at a temperature above 1,200 °C
This leads to a combustion of all organic material in the bone, thus ensuring complete deproteinisation and hence destruction and elimination of all bacteria, viruses, and prions from the original material.
The inner structure of Endobon® with its interconnecting system of macro and micro pores allows the newly formed bone to grow through the whole implant. This leads finally to a stable osseous integration of the Endobon® implant.
The biological origin confines the porosity (45-85 vol%) and density (0.4-1.6 g/ml) of the hydroxyapatite ceramic.
 
 

The Indications

Endobon® is intended for filling and reconstruction of aseptic, metaphyseal, cancellous bone defects. These bone defects might be caused by trauma or other genesis, e.g. a benign tumour, from surgery or congenital.
The blocks and cylinders are especially intended for defect filling below load bearing joints, e.g. after tibial head fractures. The granules are well indicated for irregular shaped cavities, e.g. after resection of bone cysts.
Depending on the indication accurate repositioning as well as fixation and stabilisation should be performed as if using autologous bone graft.
 

Well-tried indications for Endobon®:

  • tibial plateau fractures – blocks, cylinders
  • calcaneus fractures – blocks, cylinders
  • distal radius fractures – blocks, cylinders
  • bone cysts - granules

 

Current papers:

 
(1) Baer W, Schaller P, Carl HD. Spongy Hydroxyapatite in Hand Surgery – A Five Year Follow-Up. J Hand Surg (Br) 2002; 27B: 101-3
 
(2) Briem D, Linhart W, Lehmann W, Meenen N M, Rueger J M. Langzeitergebnisse nach Anwendung einer porösen Hydroxylapatitkeramik (Endobon) zur operativen Versorgung von Tibiakopffrakturen. Unfallchirurg 2002; 105: 128-33
 
(3) Großpeter AS, Pretzsch M, Frh. van Salis-Soglio G. Die Behandlung knöcherner Defekte mit der Hydroxylapatitkeramik Endobon® - Eine mittelfristige klinische und radiologische Verlaufsbeobachtung bei 58 Patienten. Orthopädische Praxis 2004; 40: 290-294
 
(4) Helber MU, Ulrich C. Metaphysärer Defektersatz mit Hydroxylapatitkeramik – 3- bis 4-Jahresnachuntersuchungsergebnisse. Unfallchirurg 2000; 103: 749-53
 
(5) Hing KA, Best SM, Tanner KE, Bonfield W, Revell PA. Biomechanical Assessment of Bone Ingrowth in Porous Hydroxyapatite. Journal of Materials Science: Materials in Medicine 1997; 8: 731-6
 
(6) Kehr P, Gosset F. Endobon® as a Bone Substitute in Spine Surgery. Preliminary Study in 11 Patients. Eur J Orthop Surg Traumatol 2000; 10: 217-21
 
(7) Khodadadyan-Klostermann C, Liebig T, Melcher I, Raschke M, Haas NP. Osseous Integration of Hydroxyapatite Grafts in Metaphyseal Bone Defects of the Proximal Tibia (CT-Study). Acta Chir Orthop Traumatol Cech 2002; 69(1): 16-21
 
(8) Langendorff HU, Kaivers P, Schöntag H. Die Auffüllung knöcherner Defekte mit bovinen Hydroxylapatit-Formkörpern bei Frakturen. Osteosynthese International 1994; 2: 171-6
 
(9) Liebendörfer A, Tröster S. Hydroxylapatitkeramik im klinischen Einsatz. Histologische Befunde von 23 Patienten. Unfallchirurgie 1997; 23(2): 60-8
 
(10) Müller-Mai C, Voigt C, Hering A, Rahmanzadeh R, Gross U. Madreporische Hydroxylapatitgranulate zur Füllung ossärer Defekte. Unfallchirurg 2001, 104: 221-9
 
(11) Sailer R, Lutz M, Zimmermann R, Hackl W, Gabl M, Blauth M. Minimalinvasive Therapie der dislozierten distalen metaphysären Radiuskompressionsfraktur: klinische und radiologische Ergebnisse nach gedeckter Reposition, Stiftfixation, und stabiler Defektauffüllung mit einer porösen Hydroxylapatitkeramik. Akt Traumatol 2003; 33: 26-30
 
(12) Schnettler R, Dingeldein E. Untersuchungen zur knöchernen Integration einer Hydroxylapatitkeramik (HAK) (Endobon) und bFGF im Vergleich zu autogenen Spongiosazylindern. In: Schnettler, Markgraf, editors. Knochenersatzmaterialien und Wachstumsfaktoren. Georg Thieme Verlag, Stuttgart New York, 1997; 31-42
 
(13) Südkamp NP, Schönfelder V. Arthroskopische assistierte Operationen am Tibiakopf. Langenbecks Arch Chir Suppl II (Kongreßbericht) 1995; 480-5
 
(14) Tröster SD. Die Hydroxylapatitkeramik Endobon® - Eine alternative Therapiemöglichkeit für Knochendefekte. In: Venbrocks R, von Salis-Soglio G, editors. Jahrbuch der Orthopädie 1993. Zülpich: Biermann, 1993; 231-46
 
(15) Werber KD, Brauer RB, Weiß W, Becker K. Osseous Integration of Bovine Hydroxyapatite Ceramic in Metaphyseal Bone Defects of the Distal Radius. J Hand Surg 2000; 25A: 833-41
 
 
 
For further information about the products, health care professionals should contact their Biomet Europe representative or local office. Patients with questions about products are advised to contact their local surgeon.