Bone Substitutes: Swapping Autograft for Bioactive Glass

By Bonezone

Autograft has long been the standard for reconstruction surgery when patients need bone substitutes. However, new studies show that use of bioactive glass is a viable treatment for complete bone repair, and it may come at a cheaper cost.

Recent short-term studies conducted in Finland and Ireland¹ showed that osteoconductive bone substitute demonstrated excellent results in patients who suffered from chronic osteomyelitis. Cost savings have also been noted. One hospital estimated that patients who suffer from chronic bone infection who are treated with bioactive glass could see an 80% reduction in their number of procedures, a total savings of $20,000 per patient.²

BonAlive Biomaterials Ltd., headquartered in Turku, Finland, has expanded its bioactive glass products to cater to the orthopaedic market, and is planning a launch in the U.S. market.

BONEZONE spoke with Fredrik Ollila, Ph.D., BonAlive Biomaterials Chief Executive Officer, about the science behind its bioactive glass, BonAlive®.

BONEZONE: How would you describe BonAlive?

Fredrik Ollila, Ph.D.: BonAlive is a 100% synthetic silica-based bone graft substitute which we deliver as granules in syringes for use in orthopaedic surgery, craniomaxillofacial and ear, nose and throat indications. The unique feature of BonAlive is that it inhibits bacterial growth while promoting bone growth.

BONEZONE: What is the material breakdown of BonAlive? How does it behave?

Ollila: BonAlive (S53P4 bioactive glass) can be regarded as a new generation synthetic bone graft substitute. BonAlive is not only osteoconductive, but due to its bioactive composition, it stimulates or promotes new bone formation. It works by leaching out ions that react with the body fluids, which results in transforming the granule surface chemically into one that resembles the chemical composition and structure of natural bone tissue. Leaching of the ions stimulates continuous bone tissue growth (osteostimulation) and is also the reason for the unique bacterial growth inhibiting property. In short, BonAlive is a synthetic, osteoconductive, osteostimulative and bacterial growth-inhibiting material, composed of SiO2 53%, Na2O 23%, CaO 20%, P2O5 4% by weight.

BONEZONE: In what orthopaedic applications is it used?

Ollila: The BonAlive granules are currently not available in the U.S. for orthopaedic applications.

In Europe and the rest of the world, BonAlive is used for bone cavity filling in both osteotomies and fracture repair. In the filling of bone defects derived from radical debridement in chronic osteomyelitis, BonAlive brings significant benefits by combining its unique effects of inhibiting bacterial growth and stimulating new bone formation through osteostimulation. Official indications in Europe are bone cavity filling and bone cavity filling in the treatment of chronic osteomyelitis.

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