



@article {2357,
	title = {Bone ingrowth in macroporous Bonelike                    {\textregistered} for orthopaedic applications
},
	journal = {Acta BiomaterialiaActa Biomater.},
	volume = {4},
	year = {2008},
	note = {Cited By (since 1996): 13Export Date: 21 November 2012Source: Scopusdoi: 10.1016/j.actbio.2007.06.009PubMed ID: 17716960Language of Original Document: EnglishCorrespondence Address: Santos, J.D.; FEUP - Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; email: jdsantos@fe.up.ptChemicals/CAS: Bone SubstitutesTradenames: BonelikeReferences: Akamatsu, Y., Koshino, T., Saito, T., Wada, J., Changes in osteosclerosis of the osteoarthritic knee after high tibial osteotomy (1997) Clin Orthop, 334, pp. 207-214;Coventry, M.B., Ilstrup, D.M., Wallrichs, S.L., Proximal tibial osteotomy. A critical long-term study of eighty-seven cases (1993) J Bone Joint Surg, 75 -A, pp. 196-201; 
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},
	month = {2008///},
	pages = {370 - 377},
	abstract = {The aim of this study was to evaluate the biological behaviour of porous scaffold structures of Bonelike                        {\textregistered} which is suitable for either direct clinical use or tissue engineering applications. Porous cylindrical specimens 8 {\texttimes} 10 mm were implanted in the lateral aspect of the tibia of 13 patients (mean age 54 years), during osteotomy surgery for the treatment of medial compartment osteoarthritis of the knee. Implanted cylinders were retrieved at the same time as the removal of the blade plates at 3, 6, 9 and 12 months. Scanning electron microscopy and histological evaluations were performed to observe the biological responses of human bone tissue to porous Bonelike
                        {\textregistered}. The penetration depth was determined for all implantation periods, and after 6 months it was already possible to see new bone in the centre of the implanted cylinders, which gives 100\% of penetration depth for all implantations periods except for 3 months when bone could only be seen in the peripherical region. Regarding the percentage of the area covered by new bone calculated from two-dimensional histological sections, values of 53 {\textpm} 15, 76 {\textpm} 12 and 88 {\textpm} 9\% were achieved for 6, 9 and 12 months, respectively. Due to its structural features porous Bonelike
                        {\textregistered} permitted effective vascularization and bone ingrowth, and therefore was fully osteointegrated as shown in the histological surveys. A slow biomaterial degradation with implantation time is envisaged since the material has displayed surface degradation. Bonelike
                        {\textregistered} scaffolds show potential for complete ingrowth of osseous tissue and restoration of vascularization throughout the defected site. {\textcopyright} 2007.
},
	keywords = {adult, aged, article, biomaterial, bone defect, Bone graft, bone growth, Bone Regeneration, Bone Substitutes, bone tissue, Bonelike, clinical article, controlled study, Female, histology, human, human tissue, Humans, implant, knee osteoarthritis, male, materials testing, Microscopy, Electron, Scanning, Middle Aged, molecular scaffold, Orthopaedic, orthopedics, Osseointegration, Osteoarthritis, osteotomy, porosity, Porous materials, priority journal, Prostheses and Implants, Scanning electron microscopy, tibia, Time Factors, Tissue engineering, tissue section, vascularization, {\textregistered}},
	isbn = {17427061 (ISSN)},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-38949142954\&partnerID=40\&md5=ab5a278b6d421b9e8e96f9397b7c54e1},
	author = {Gutierres, M. and Lopes, M.A. and Sooraj Hussain, N. and Lemos, A.F. and Ferreira, J.M.F. and Afonso, A. and Cabral, A.T. and Almeida, L. and Santos, J.D.}
}
@article {2368,
	title = {Opening wedge high tibial osteotomy using 3D biomodelling Bonelike{\textregistered} macroporous structures: Case report},
	journal = {Journal of Materials Science: Materials in MedicineJ. Mater. Sci. Mater. Med.},
	volume = {18},
	year = {2007},
	note = {Cited By (since 1996): 9Export Date: 21 November 2012Source: ScopusCODEN: JSMMEdoi: 10.1007/s10856-007-3171-xPubMed ID: 17569003Language of Original Document: EnglishCorrespondence Address: Santos, J.D.; Laborat{\'o}rio de Biomateriais, Instituto de Engenharia Biom{\'e}dica (INEB), Rua do Campo Alegre 823, Porto 4150-180, Portugal; email: jdsantos@fe.up.ptChemicals/CAS: calcium phosphate, 10103-46-5, 13767-12-9, 14358-97-5, 7758-87-4; hydroxyapatite, 1306-06-5, 51198-94-8; Bone Substitutes; Calcium Phosphates; Ceratite, 124097-42-3; HydroxyapatitesTradenames: BonelikeReferences: Gaasbeek, R.D.A., Welsing, R.T.C., Verdonschot, N., Rijnberg, W.J., Van Loon, C.J.M., Van Kampen, A., (2005) Knee Surg. Sports Traumatol. Arthrosc., 13, p. 689. , 8;Scott, W.N., Clarke, H.D., (2004) Orthopedics, 27, p. 975. , 9; 
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},
	month = {2007///},
	pages = {2377 - 2382},
	abstract = {Two synthetic calcium phosphates in porous wedge shape, Bonelike{\textregistered} and a commercial HA/β-TCP biphasic material, were used as an alternative to bone autografts and allografts in the treatment of medial compartment osteoarthritis of varus knees. The structure of Bonelike{\textregistered} has a 3D architecture that is computer controlled, and a composition that mimics the mineral composition of natural bone. The HA/β-TCP biphasic material used as a control material in this study was prepared using conventional foaming based methods. No signs of inflammatory reactions were observed post-operatively for both materials. After 4 months signs of fusion at the osteotomy site and good integration of the implanted wedges were observed, showing good mechanical resistance. Concerning the final correction attained, the left knee revealed a satisfactory valgus of 10{\textdegree}, but the right one only had a final value of 6{\textdegree}. The clinical evaluation using International Knee Score (IKS) showed good outcome in all parameters with complete range of motion in both knees and climbing stairs without crutches with only slight pain. {\textcopyright} 2007 Springer Science+Business Media, LLC.},
	keywords = {adult, article, Biological organs, Biomodeling, Bone, bone allograft, Bone graft, bone mineral, Bone Substitutes, calcium phosphate, Calcium phosphates, case report, climbing, clinical evaluation, Computer simulation, Grafts, human, Humans, hydroxyapatite, Hydroxyapatites, Imaging, Three-Dimensional, knee, knee pain, Macroporous structures, male, Mechanical properties, Middle Aged, Osteoarthritis, Osteoarthritis, Knee, Osteoblasts, osteotomy, pain assessment, porosity, Porous wedge shapes, priority journal, Prostheses and Implants, range of motion, structure analysis, tibia, tibia osteotomy, Tibial osteotomy, Valgus, valgus knee},
	isbn = {09574530 (ISSN)},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-36448991200\&partnerID=40\&md5=856e2db65f4b4dc72a1128388ebc479a},
	author = {Gutierres, M. and Dias, A.G. and Lopes, M.A. and Hussain, N.S. and Cabral, A.T. and Almeida, L. and Santos, J.D.}
}
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Hing, K.A., Assessment of porous hydroxyapatite for bone replacement (1996), (Ph D Thesis). London: University of LondonLopes, M.A., Knowles, J.C., Santos, J.D., Direct and indirect effects of P 2O 5-glass reinforced-hydroxyapatite composites and growth and function of osteoblast-like cells (2000) Biomaterials, 21, pp. 1165-1172; 
Lopes, M.A., Knowles, J.C., Santos, J.D., Flow cytometry for assessing biocompatibility (1998) J Biomed Mater Res, 41, pp. 649-656; 
Ross, M.H., Romrell, L.J., Kaye, G.I., (1995) Histology - A Text and Atlas, , 3rd ed. Baltimore, MD: Williams \& Wilkins; 
Lobato, J.V., Hussain, N.S., Botelho, C.M., Assessment of the potential of Bonelike{\textregistered} graft for bone regeneration by using an animal model (2005) Key Eng Mater, 284-286, pp. 877-880; 
Duarte, F., Lopes, M.A., Santos, J.D., Bonelike{\textregistered} composites for the regeneration of bone lesions (2004) Mater Sci Forum, 455-456, pp. 370-373; 
Laurencin, C.T., (2003) Bone Graft Substitutes, , West Conshohocken, PA: ASTM International
},
	month = {2006///},
	pages = {953 - 958},
	abstract = {Synthetic bone grafts provide an alternative to autografts and allografts. Bonelike{\textregistered} is a patented synthetic bone graft that mimics the mineral composition of bone. The aim of the present work was to assess the biological behavior of Bonelike{\textregistered} graft in humans, before using the material in orthopedic applications of bone regeneration, for example, in opening wedge high tibial osteotomies for medial knee osteoarthritis. Bonelike{\textregistered} granules were implanted in cortical bone of 11 patients undergoing osteotomies, and new bone formation, osteoconductive properties, and resorption characteristics of the granules were analyzed. The granules ranged from 500 to 1000 μm and were implanted in the lateral aspect of the tibia. The patients{\textquoteright} mean age was 59 years (range 48 to 70 years); there were eight women and three men, all suffering from medial compartment osteoarthritis of the knee. At surgery, a 1 {\texttimes} 1 {\texttimes} 1-cm cortical defect was created 3 cm distal to the entry point of the screws, in line with the long axis of tibia. The implanted Bonelike{\textregistered} graft sample was extracted for analysis during removal of the metallic prosthesis after implantation times of 6, 9, and 12 months. Radiological follow-up, scanning electron microscopy, histological analysis, and histomorphometric measurements were conducted on the retrieved samples to assess bone regeneration in the defect area. Osteoconductive capacity was demonstrated by extensive mature bone formation around the implanted granules and high levels of percentage bone-to-graft contact (from 67-84\%). Bonelike{\textregistered} acted as an excellent bioactive scaffold, allowing the migration, proliferation, and differentiation of bone cells on its surface, and therefore regeneration of the defects was achieved in a rapid, controlled manner. Our results suggest that Bonelike{\textregistered} graft is an excellent candidate for orthopedic applications where rapid new bone formation is a fundamental requirement. {\textcopyright} 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.},
	keywords = {adult, aged, article, Bone, Bone and Bones, bone cell, bone conduction, bone development, Bone graft, bone prosthesis, bone radiography, Bone Regeneration, bone screw, Bone Substitutes, bone transplantation, Bonelike{\textregistered}, cell differentiation, cell migration, cell proliferation, Clinical applications, clinical article, controlled study, Female, follow up, Histological analysis, histology, human, Humans, knee osteoarthritis, male, Microscopy, Electron, Scanning, Middle Aged, morphometrics, orthopedics, ossification, Osteoconduction, Osteogenesis, osteolysis, Pathology, priority journal, Prostheses and Implants, prostheses and orthoses, prosthesis material, Scanning electron microscopy, surgical technique, Synthetic bone graft, tibia osteotomy, ultrastructure},
	isbn = {07360266 (ISSN)},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-33744465532\&partnerID=40\&md5=ef625229b1616ab24217a9235a89286e},
	author = {Gutierres, M. and Hussain, N.S. and Lopes, M.A. and Alfonso, A. and Cabral, A.T. and Almeida, L. and Santos, J.D.}
}
@book {2433,
	title = {Biological behaviour of Bonelike{\textregistered} graft implanted in the tibia of humans},
	series = {Key Engineering MaterialsKey Eng Mat},
	volume = {284-286},
	year = {2005},
	note = {Cited By (since 1996): 4Export Date: 21 November 2012Source: ScopusCODEN: KEMAELanguage of Original Document: EnglishCorrespondence Address: Gutierres, M.; Faculdade de Medicina da Universidade do Porto, Hospital de S{\~a}o Jo{\~a}o, Largo Hern{\^a}ni Monteiro, 4200 Porto, Portugal; email: m.gutierres@clix.ptReferences: Bauer, T.W., Muschler, G.F., Bone Graft Materials. An Overview of the Basic Science (2000) Clin orthop Rel. Res, 371, pp. 10-27;Perry, C.R., Bone Repair Techniques, Bone Graft and Bone Graft Substitutes (1999) Clin Orthop Rel Res, 360, pp. 71-86; 
Ilan, D.I., Ladd, A.L., Bone graft substitutes (2003) Operative Tech. in plastic and Reconstructive Surgery, 9 (4), pp. 151-160; 
Santos, J.D., Hastings, G.W., Knowles, J.C., Sintered Hydroxyapatite Compositions and Method for the Preparation Thereof European Patent WO 0068164Lopes, M.A., Glass reinforced hydroxyapatite composites: Structural, Physicochemical characterisation and Biological performance (1999), PhD thesis, FEUP, University of Porto, PortugalCoventry, M.B., Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee: A preliminary report (1965) J. Bone Joint Surg.Am, 47, p. 984; 
Lopes, M.A., Santos, J.D., (2001) J.Biomed Mat Res, 54, pp. 463-469
},
	month = {2005///},
	pages = {1041 - 1044},
	abstract = {This paper reports the ability of Bonelike{\textregistered} to regenerate bone defected areas when implanted in the tibia of 3 patients (average age of 59 years) during a high tibial osteotomy (HTO) to treat medial compartment osteoarthritis of the knee. Bonelike{\textregistered} is a synthetic bone graft designed to mimic the inorganic composition of bone using a patent process that consists of liquid sintering hydroxyapatite in the presence of CaO-P                        2O
                        5 based glass. The preliminary clinical evaluation performed showed that an intimate contact between new formed bone and Bonelike{\textregistered} was established (67{\textpm}10\%), with no fibrous interface. Therefore, Bonelike{\textregistered} is a single-handedly viable osteoconductive synthetic grafting material as it has been demonstrated from the profiles of radiological, histological and scanning electron microscopy analyses for the six months implantation period.
},
	keywords = {Biological behavior, Bone, Bonelike{\textregistered} graft, Clinical trials, histology, hydroxyapatite, Implants (surgical), Radiology, Scanning electron microscopy, Surgery, Synthetic grafting material},
	isbn = {10139826 (ISSN)},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-33744540330\&partnerID=40\&md5=c7f109dc068a35ed53047b8426a85a1d},
	author = {Gutierres, M. and Hussain, N.S. and Afonso, A. and Almeida, L. and Cabral, T. and Lopes, M.A. and Santos, J.D.}
}
@article {2453,
	title = {Bone substitutes: General concepts and "state of the art"},
	journal = {Substitutos {\'o}sseos: Conceitos gerais e estado actualArquivos de MedicinaArq. Med.},
	volume = {19},
	year = {2005},
	note = {Export Date: 21 November 2012Source: ScopusCODEN: ARQMELanguage of Original Document: PortugueseCorrespondence Address: Gutierres, M.; Servi{\c c}o de Ortopedia, Hospital de S{\~a}o Jo{\~a}o, Alameda Prof. Hern{\^a}ni Monteiro, 4200-319 Porto, Portugal; email: m.gutierres@sapo.ptChemicals/CAS: calcium phosphate, 10103-46-5, 13767-12-9, 14358-97-5, 7758-87-4; calcium sulfate, 13397-24-5, 23296-15-3, 7778-18-9; fibroblast growth factor, 62031-54-3; transforming growth factor, 76057-06-2References: Laurencin, C.T., Chapter I- Bone graft and bonegraft substitutes a brief history (2004) Bone Graft Substitute - ASTM International, , Laurencin CT, editors;Ratner, B.D., A history of Biomaterials (2004) Biomaterials Science. 2 nd Edition, pp. 10-19. , Ratner, edits. Elsevier Inc; 
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},
	month = {2005///},
	pages = {153 - 162},
	abstract = {Bone grafts are nowadays the subject of extensive research worldwide, aimed at overcoming limitations associated with the use of autografts or bone banks to fill bone defects. Additionally, the use of osteogenic substances opens new perspectives in the treatment of fractures, pseudarthroses and vertebral arthrodeses. Due to the large amount of information available in the area of bone grafts, this paper aims not only to revise general concepts but also to summarize what has been published recently in the area of bone substitutes for bone regeneration. {\textcopyright}ArquiMed, 2006.},
	keywords = {Autografts, biomaterial, bone defect, bone demineralization, bone development, Bone graft, Bone growth factors, Bone morphogenetic protein, bone prosthesis, calcium phosphate, calcium sulfate, cortical bone, fibroblast growth factor, fracture, health care facility, health status, human, hydroxyapatite, platelet derived growth factor, pseudarthrosis, publication, review, somatomedin C derivative, spondylarthritis, transforming growth factor},
	isbn = {08713413 (ISSN)},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-33748855173\&partnerID=40\&md5=494dbb696981df5711e7dda7d1393224},
	author = {Gutierres, M. and Ascens{\~a}o Lopes, M. and Sooraj Hussain, N. and Trigo Cabral, A. and Almeida, L. and Domingos Santos, J.}
}
@book {2499,
	title = {In Vitro Mineralisation of Human Bone Marrow Cells Cultured on Bonelike{\textregistered}},
	series = {Key Engineering MaterialsKey Eng Mat},
	volume = {254-256},
	year = {2004},
	note = {Conference code: 62053Cited By (since 1996): 6Export Date: 21 November 2012Source: ScopusCODEN: KEMAELanguage of Original Document: EnglishCorrespondence Address: Costa, M.A.; Inst. Cie. Blomed. de Abel Salazar, Universidade do Porto, Largo Abel Salazar, 4000 Porto, PortugalReferences: Santos, J.D., Campbell, J.K., Winston, G.H., European Patent N{\textdegree} WO0068164, 2000Lopes, M.A., Knowles, J.C., Santos, J.D., (2000) Biomaterials, 21, p. 1905;Lopes, M.A., Monteiro, F.J., Santos, J.D., (1999) J. Biomed. Mater. Res.:App. Biomater., 48, p. 734; 
Lopes, M.A., Knowles, J.C., Kuru, L., Santos, J.D., Monteiro, F.J., Olsen, I., (1998) J. Biomed. Mater. Res., 41, p. 649; 
Lopes, M.A., Knowles, J.C., Santos, J.D., Monteiro, F.J., Olsen, I., (2000) Biomaterials, 21, p. 1165; 
Ferraz, M.P., Fernandes, M., Santos, J.D., Monteiro, F.J., (2001) J. Mat. Sci.: Mat. Med., 12, p. 629; 
Lopes, M.A., Santos, J.D., Monteiro, F.J., Ohtsuki, C., Osaka, A., Kaneko, S., Inoue, H., (2001) J. Biomed. Mater. Res., 54, p. 463; 
Duarte, F., Santos, J.D., Afonso, A., Advanced Materials Forum, , in press; 
Coelho, M.J., Fernandes, M.H., (2000) Biomaterials, 21, p. 1095; 
Kleerekoper, M., (1996) Principles of Bone Biology, p. 1053. , Academic Press
},
	month = {2004///},
	pages = {821 - 824},
	address = {Porto},
	abstract = {Bonelike{\textregistered} is a CaO-P                        2O
                        5 based glass-reinforced hydroxyapatite (HA) designed to mimic the inorganic composition of the bone tissue. This work evaluates the response of human bone marrow cells to Bonelike{\textregistered} concerning cell proliferation and osteoblast differentiation. HA was used as control material. Results showed that Bonelike{\textregistered} allowed the proliferation of bone marrow cells and their complete differentiation, as evidenced by the formation of cell-mediated mineralisation. In comparison with HA, Bonelike{\textregistered} had a positive effect on the expression of alkaline phosphatase and also on the formation of a mineralised matrix, two osteoblast markers.
},
	keywords = {Bone, Bonelike{\textregistered}, Cell culture, cell proliferation, Composition, Grafts, Human bone marrow cells, hydroxyapatite, In vitro mineralisation, mineralization, Scanning electron microscopy, Sintering, X ray diffraction},
	isbn = {10139826 (ISSN)},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-0346255201\&partnerID=40\&md5=470ac94fd75d1a53b887d44f59fbf7d1},
	author = {Costa, M.A. and Gutierres, M. and Almeida, L. and Lopes, M.A. and Santos, J.D. and Fernandes, M.H.},
	editor = {Barbosa M.A. and Monteiro F.J. and Correia R. and Leon B.}
}
