InQu™ as a Bone Graft Substitute

Bone graft substitutes are commonly used to support biological repair of bony defects resulting from trauma and osteotomy. While numerous ceramic and calcium salt-based substitutes are available for this purpose, they sometimes prove difficult to handle, have variable and unpredictable rates of resorption, and interfere with the surgeon’s ability to radiographically monitor progressive bone healing (1).

InQu Bone Graft Substitute was strategically designed to provide surgeons with a unique solution to fill bony voids in the extremities and pelvis and to offer distinct advantages over other available substitutes. A unique combination of hyaluronic acid (HyA) and resorbable poly(lactide-co-glycolide) (PLGA), InQu creates a microenvironment that is conducive to new bone formation. PLGA serves to create the porous structure of InQu required for cellular infiltration. Hyaluronic acid is reported to facilitate cell attachment by increasing water absorption within tissues (2,3). In addition, HyA is reported to support angiogenesis, an essential early event in bone formation (4,5).

InQu has many advantages over existing bone graft substitutes, including its superior handling characteristics. InQu easily wicks fluids, and when combined with bone autograft, saline, bone marrow aspirate or blood, results in a cohesive implant. Additionally, InQu’s radiolucency allows surgeons to easily distinguish new bone growth on x-ray. The rate of InQu resorption and its replacement by newly formed bone is consistent with the rate of bone remodeling at the site of implantation, thus providing the surgeon with predicable results.

  1. Buchholz RW. Nonallograft osteoconductive bone graft substitutes.  Clin Orthop Rel Res 2002; 395:44-52.
  2. Ogston AG, Sherman TF. Effects of hyaluronic acid upon diffusión of solutes and flow of solvent. J Physiol 1961; 17:1-8.
  3. Hall CL, Wang C, Lange LA, Turley EA. Hyaluronan and the hyaluronan receptor RHAMM promote focal adhesion turnover and transient tyrosine kinase activity. J Cell Biol 1994; 126:575-588.
  4. West DC, Hampson IN, Arnold F, Kumar S.  Angiogenesis induced by degradation products of hyaluronic acid.  Science 1985; 14:1324-1326.
  5. Sasaki T, Watanabe C. Stimulation of osteoinduction in bone wound healing by high-molecular weight hyaluronic acid. Bone 1995; 16:9-15.

InQu was granted 510(k) clearance in 2007 and is currently available for use.

 


Sham Control


InQu Treated

Unoperated Control

Faxitron x-ray assessment of new bone formation at three months showing incomplete bone formation in a representative defect-only control specimen (top) as compared to a femur treated with InQu granules (middle) and an unoperated femur (bottom).   

 





 

 

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