Tissue response in dogs to dense hydroxylapatite implantation in the femur.
Six and eight years after the implantation of both granular and solid ceramic hydroxylapatite forms in the femurs of beagle dogs, histologic examination demonstrated that the implants were totally encased in dense mature bone. The endosteal and periosteal surfaces appeared normal, and no resorption of the solid implants was observed. However, at six years, a few granules located at the periosteal surface showed interdigitation of connective tissue stalks, with large multinucleated cells at the interface with the implant. This phenomenon may represent some limited resorptive activity on the surfaces of these few isolated granules. Initially, radiographs showed exaggerated degrees of bone deposition on the endosteal surface under the solid implants (discs), as opposed to a less pronounced endosteal response to the implants of particulate material. In some cases, particularly with the disc implants, cracks were found in the ceramic material six years after implantation. These cracks, on staining, were found to be filled with amorphous material, suggesting an osseous matrix. The results of these long-term studies indicate that such hydroxylapatite implants in bone are highly biocompatible. Bone deposition and maturation on the implant surface resulted in a homogeneous bone/implant interface in which the host tissues appeared to respond to the implant as if it were normal bone.