The biological performance of calcium phosphate ceramics in an infected implantation site: I. Biological performance of hydroxyapatite during Staphylococcus aureus infection.

In the present study the biological performance of macroporous and dense hydroxyapatite after implantation in the rat middle ear was evaluated during an induced Staphylococcus aureus middle ear infection. The course of the infection was similar to that in the absence of an implant. Hydroxyapatite was frequently integrated with fibrous ingrowths in the middle ear lumen, originating solely from the infection. Good epithelial covering of the implant with all types of epithelial cells of importance for middle ear defence, was found. Increase of the exudate in the pores due to the infection was relatively small, and most of the exudate was restricted to pores on the implant surface. The bony tissue in the pores was not influenced significantly by the induced infection. Degradation of hydroxyapatite was consistent with earlier results obtained in the non-infected middle ear. The results obtained so far suggest that hydroxyapatite is highly suitable for middle ear implantation.