Novel methodology for assessing biomaterial-biofluid interaction in cancellous bone

Understanding the cement flow behaviour and accurately predicting the cement placement within the vertebral body is extremely challenging. Vertebral cancellous bone displays highly complex geometrical structures and architectural inhomogeneities over a range of length scales, thus making the scientific understanding of the cement injection behaviour difficult in clinical or cadaveric studies. Previous experimental studies on cement flow have used open-porous aluminum foam to represent osteoporotic bone. Although the porosity was well controlled, the geometrical structure of each of the foams was inherently unique. This paper presents novel methodology using customized, reproducible and pathologically representative three-dimensional bone surrogates to help study biomaterial–biofluid interaction. The aim was to provide a robust tool for comprehensive assessment of biomaterial injection behaviour through controlling the bone surrogate morphology and the injection parameters (i.e. needle gauge, needle placement, flow rate and injected volume), measuring the injection pressure, and allowing the visualization and quantitative analysis of the spreading distribution. This methodology provides a clinically relevant representation of cement flow patterns and a tool for validating computational simulations.