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Background: A significant bone defect is a condition wherein the bone cannot repair spontaneously. Therefore, replacing bone defects with bone substitution remains a reconstructive concern for orthopaedic surgeons. Bone Graft Substitution (BGS) are classified broadly, such as bone grafts (autograft, allograft, and xenograft) synthetic ceramics (hydroxyapatite, calcium sulphate). This study aims to determine the effect of various Bone Graft Substitute on the healing process of bone defects assessed based on the area of callus formation and levels of alkaline phosphatase (ALP).     Methods: The study design was an in vivo laboratory experimental approach with a randomized post-test only control group design. The 36 experimental animals that matched the inclusion criteria were divided into five groups, in each one of control positive group, one of control negative group, and three of treatment group. The bone graft substitution used in this study is a synthetic ceramic, namely Synthetic HA-Ca10(PO4)6(OH)2 - BONGROS®, Bone Graft Substitution Nanocrystalline HA-CaSO4-PEROSSAL®, and also hydroxyapatite Bovine. After selecting rats, we performed osteotomy on the femur to the made bone defect. After 30 days, murine models were harvested. Then, we measure callus formation using radiological examination and ALP level serum    Results: From Callus formation, Nanocrystalline HA-CaSO4 is the highest (86.54 ± 4.24604) compared with other groups and significantly (p:0.021) increase in callus formation than the other experimental groups. Then, from the ALP level, Bovine is the highest (9.287 ± 0.58586) but did not significantly compare with K-neg, and the second one is Nanocrystalline HA-CaSO4 higher than KP-1, and it has a significantly higher levels serum ALP rather than K-Neg.     Conclusion: Bone Graft Substituted using Nanocrystalline HA-CaSO4 is a good material that can repair and increase callus formation in fracture model rats with bone defects.

f1000research

The effect of bone graft substitute in healing fractures with bone defects through examination of alkaline phosphatase and radiology in the murine model (Rattus norvegicus) Wistar strain