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Goetz JE, Brouillette MJ, Sakyi MY, Paulsen DP, Petersen EB, Fredericks DC. A New Method for Creating Impact-Induced Intra-Articular Fractures in a Rabbit Model Induces Severe Post-Traumatic Osteoarthritis. J Orthop Trauma 2024; 38:e133-e141. [PMID: 38206679 DOI: 10.1097/bot.0000000000002757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVES The objective of this work was to develop a model of intra-articular fracture (IAF) in a rabbit and document the speed and severity of degenerative joint changes after fracture fixation. METHODS With Institutional Animal Care & Use Committee approval, impact-induced IAFs were created in the distal tibia of 16 New Zealand White rabbits. Fractures were fixed with a plate and screws. Pain and function were monitored at regular postoperative intervals with limb loading analysis. Twelve or 26 weeks after fracture, animals were euthanized for histological assessment of cartilage degeneration and micro-computed tomography analysis of bone histomorphometry. RESULTS Eleven animals successfully completed the study. Maximum foot force in the fractured limb was 41% ± 21% lower than preoperative values ( P = 0.006) 12 weeks after fracture and remained 25% ± 13% lower ( P = 0.081) after 26 weeks. Cortical bone mineral density in micro-computed tomography images was 34% ± 13% lower 12 weeks after fracture ( P < 0.001) and remained (42% ± 8%) lower 26 weeks after fracture ( P < 0.001). Twelve weeks after fracture, Mankin scores of cartilage degeneration were significantly higher in the medial talus ( P = 0.007), lateral talus ( P < 0.001), medial tibia ( P = 0.017), and lateral tibia ( P = 0.002) of the fractured limb compared with the uninjured contralateral limb. Average Mankin scores in the talus increased from 12 to 26 weeks (5.9 ± 0.9 to 9.4 ± 0.4; P < 0.001 lateral; 5.4 ± 1.8 to 7.8 ± 2.0; P = 0.043 medial), indicating substantial and progressive joint degeneration. CONCLUSIONS The ankle joint of the New Zealand White rabbit provides the smallest available model of impact-induced IAF that can be treated with clinically relevant techniques and replicates key features of healing and degeneration found in human patients.
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Affiliation(s)
- Jessica E Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA
| | - Marc J Brouillette
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Maxwell Y Sakyi
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Danielle P Paulsen
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Emily B Petersen
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Douglas C Fredericks
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
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Garot C, Schoffit S, Monfoulet C, Machillot P, Deroy C, Roques S, Vial J, Vollaire J, Renard M, Ghanem H, El-Hafci H, Decambron A, Josserand V, Bordenave L, Bettega G, Durand M, Manassero M, Viateau V, Logeart-Avramoglou D, Picart C. 3D-Printed Osteoinductive Polymeric Scaffolds with Optimized Architecture to Repair a Sheep Metatarsal Critical-Size Bone Defect. Adv Healthc Mater 2023; 12:e2301692. [PMID: 37655491 DOI: 10.1002/adhm.202301692] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/10/2023] [Indexed: 09/02/2023]
Abstract
The reconstruction of critical-size bone defects in long bones remains a challenge for clinicians. A new osteoinductive medical device is developed here for long bone repair by combining a 3D-printed architectured cylindrical scaffold made of clinical-grade polylactic acid (PLA) with a polyelectrolyte film coating delivering the osteogenic bone morphogenetic protein 2 (BMP-2). This film-coated scaffold is used to repair a sheep metatarsal 25-mm long critical-size bone defect. In vitro and in vivo biocompatibility of the film-coated PLA material is proved according to ISO standards. Scaffold geometry is found to influence BMP-2 incorporation. Bone regeneration is followed using X-ray scans, µCT scans, and histology. It is shown that scaffold internal geometry, notably pore shape, influenced bone regeneration, which is homogenous longitudinally. Scaffolds with cubic pores of ≈870 µm and a low BMP-2 dose of ≈120 µg cm-3 induce the best bone regeneration without any adverse effects. The visual score given by clinicians during animal follow-up is found to be an easy way to predict bone regeneration. This work opens perspectives for a clinical application in personalized bone regeneration.
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Affiliation(s)
- Charlotte Garot
- CNRS EMR 5000 Biomimetism and Regenerative Medicine (BRM), INSERM U1292 Biosanté, CEA, Université Grenoble Alpes, 17 avenue des Martyrs, Grenoble, F-38054, France
| | - Sarah Schoffit
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Cécile Monfoulet
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Paul Machillot
- CNRS EMR 5000 Biomimetism and Regenerative Medicine (BRM), INSERM U1292 Biosanté, CEA, Université Grenoble Alpes, 17 avenue des Martyrs, Grenoble, F-38054, France
| | - Claire Deroy
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Samantha Roques
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Julie Vial
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Julien Vollaire
- INSERM U1209, Institute of Advanced Biosciences, Grenoble, F-38000, France
- Institute of Advanced Biosciences, Université Grenoble Alpes, Grenoble, F-38000, France
| | - Martine Renard
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Hasan Ghanem
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Hanane El-Hafci
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Adeline Decambron
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Véronique Josserand
- INSERM U1209, Institute of Advanced Biosciences, Grenoble, F-38000, France
- Institute of Advanced Biosciences, Université Grenoble Alpes, Grenoble, F-38000, France
| | - Laurence Bordenave
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Georges Bettega
- INSERM U1209, Institute of Advanced Biosciences, Grenoble, F-38000, France
- Service de Chirurgie Maxillo-Faciale, Centre Hospitalier Annecy Genevois, 1 avenue de l'hôpital, Epagny Metz-Tessy, F-74370, France
| | - Marlène Durand
- INSERM, Institut Bergonié, University of Bordeaux, CIC 1401, Bordeaux, F-33000, France
- CIC-IT, INSERM, Institut Bergonié, CHU de Bordeaux, CIC 1401, Bordeaux, F-33000, France
| | - Mathieu Manassero
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | - Véronique Viateau
- Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, F-94704, France
- CNRS, INSERM, ENVA, B3OA, Université Paris Cité, Paris, F-75010, France
| | | | - Catherine Picart
- CNRS EMR 5000 Biomimetism and Regenerative Medicine (BRM), INSERM U1292 Biosanté, CEA, Université Grenoble Alpes, 17 avenue des Martyrs, Grenoble, F-38054, France
- Institut Universitaire de France (IUF), 1 rue Descartes, Paris CEDEX 05, 75231, France
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Pappa EI, Barbagianni MS, Georgiou SG, Athanasiou LV, Psalla D, Vekios D, Katsarou EI, Vasileiou NGC, Gouletsou PG, Galatos AD, Prassinos NN, Gougoulis DA, Angelidou M, Tsioli V, Fthenakis GC, Sideri AI. The Use of Stromal Vascular Fraction in Long Bone Defect Healing in Sheep. Animals (Basel) 2023; 13:2871. [PMID: 37760271 PMCID: PMC10525334 DOI: 10.3390/ani13182871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/19/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
The objectives of the present study were to evaluate (a) the feasibility of using stromal vascular fraction (SVF) and nanocrystalline hydroxyapatite (nHA) paste in combination for the treatment of segmental bone defect, (b) the quality of the callus produced, (c) the potential improvement of the autograft technique, and (d) the direct comparison of the biomaterial to the use of autogenous cancellous bone. Unilateral, segmental mid-diaphyseal bone defect was created on the right metatarsus of skeletally mature sheep animals (n = 24) under anesthesia (D0). Residual segments were stabilized by stainless-steel plates and appropriate screws. Defects were managed as follows: group A: use of nHA paste to filling, group B: use of autogenous bone graft mixed with nHA bone paste, placed in defect, group C: use of SVF mixed with nHA bone paste injected into defect, group D: use of bone graft and SVF with nHA paste before apposition in bone defect. SVF had been previously isolated from adipose tissue of the animals intra-operatively after digestion with collagenase solution and neutralization. Animals were evaluated clinically and by X-raying and ultrasonographic examination of the defect, at regular intervals, until D90. Ultrasonographic assessment performed along the length of the defect included calculation of the length of the bone defect and assessment of vascularization. SVF was successfully isolated from group C and D animals, with the average yield being 1.77 × 106 cells. The comparison of clinical scores (based on the 'Kaler scale') on each post-operative day indicated significant differences between the four groups on D1 to D30 (p < 0.01); the median clinical score within group A was 2.5 for D1-D30 and 1 for the entire period; respective scores for other groups were 1.5 (p = 0.07) and 0 (p = 0.033). Differences in radiographic assessment scores were significant for scores obtained on D60 (p = 0.049) and D90 (p = 0.006). There was a significant difference between the four groups in the length of the bone defect, as assessed ultrasonographically, for the entire length of the study; median values were 8, 8.5, 6, and 8 mm for groups A, B, C, and D, respectively (p = 0.008). There was a significance in the differences between median scores obtained during the histopathological examination: 2, 11, 13.5, and 12 for group A, B, C, and D (p = 0.022). There was an inverse correlation between the overall scores of histopathological evaluations and the length of the bone defect (observed on D90) (p < 0.0001) and a correlation between the overall scores and the radiographic assessment scores (obtained on D90) (p < 0.0001). This is the first study in which the efficacy of fresh autologous Stromal Vascular Fraction (SVF) from adipose tissue in enhancing bone healing in a long, weight-bearing, diaphyseal bone was evaluated. It is concluded that the lumbosacral region was an attractive site for harvesting adipose tissue, the use of SVF contributed to faster rehabilitation post-operatively, and SVF significantly enhanced bone formation; in general, the results indicated an osteogenic potential of SVF comparable to the gold standard autologous bone graft.
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Affiliation(s)
- Elena I. Pappa
- Faculty of Veterinary Science, University of Thessaly, 43100 Karditsa, Greece
| | | | | | | | - Dimitra Psalla
- School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dionysios Vekios
- School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Eleni I. Katsarou
- Faculty of Veterinary Science, University of Thessaly, 43100 Karditsa, Greece
| | | | - Pagona G. Gouletsou
- Faculty of Veterinary Science, University of Thessaly, 43100 Karditsa, Greece
| | | | - Nikitas N. Prassinos
- School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | - Marianna Angelidou
- School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Vicky Tsioli
- Faculty of Veterinary Science, University of Thessaly, 43100 Karditsa, Greece
| | - George C. Fthenakis
- Faculty of Veterinary Science, University of Thessaly, 43100 Karditsa, Greece
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Isaacson N, Lopez-Ambrosio K, Chubb L, Waanders N, Hoffmann E, Witt C, James S, Prawel DA. Compressive properties and failure behavior of photocast hydroxyapatite gyroid scaffolds vary with porosity. J Biomater Appl 2022; 37:55-76. [PMID: 35331033 DOI: 10.1177/08853282211073904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hydroxyapatite is commonly used in tissue engineered scaffolds for bone regeneration due to its excellent bioactivity and slow degradation rate in the human body. A method of layer-wise, photopolymerized viscous extrusion, a type of additive manufacturing, was developed to fabricate hydroxyapatite gyroid scaffolds with 60%, 70%, and 80% porosities. This study uses this method to produce and evaluate calcium phosphate-based scaffolds. Gyroid topology was selected due to its interconnected porosity and superior, isotropic mechanical properties compared to typical rectilinear lattice structures. These 3D printed scaffolds were mechanically tested in compression and examined to determine the relationship between porosity, ultimate compressive strength, and fracture behavior. Compressive strength increased with decreasing porosity. Ultimate compressive strengths of the 60% and 70% porous gyroids are comparable to that of human cancellous bone, and higher than previously reported for hydroxyapatite rectilinear scaffolds. These gyroid scaffolds exhibited ultimate compressive strength increases between 1.5 and 6.5 times greater than expected, based on volume of material, as porosity is decreased. The Weibull moduli, a measure of failure predictability, were predictive of failure mode and found to be in the accepted range for engineering ceramics. The gyroid scaffolds were also found to be self-reinforcing such that initial failures due to minor manufacturing inconsistencies did not appear to be the primary cause of early failure of the scaffold. The porous gyroids exhibited scaffold failure characteristics that varied with porosity, ranging from monolithic failure to layer-by-layer failure, and demonstrated self-reinforcement in each porosity tested.
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Affiliation(s)
- Nelson Isaacson
- School of Advanced Materials Discovery, 3447Colorado State University, Fort Collins, CO, USA
| | | | - Laura Chubb
- College of Veterinary Medicine and Biomedical Sciences, 3447Colorado State University, Fort Collins, CO, USA
| | - Nathan Waanders
- School of Biomedical Engineering, 3447Colorado State University, Fort Collins, CO, USA
| | - Emily Hoffmann
- School of Biomedical Engineering, 3447Colorado State University, Fort Collins, CO, USA
| | - Connor Witt
- Department of Chemical and Biological Engineering, 3447Colorado State University, Fort Collins, CO, USA
| | - Susan James
- School of Advanced Materials Discovery, 3447Colorado State University, Fort Collins, CO, USA.,School of Biomedical Engineering, 3447Colorado State University, Fort Collins, CO, USA.,Mechanical Engineering, 3447Colorado State University, Fort Collins, CO, USA
| | - David A Prawel
- School of Advanced Materials Discovery, 3447Colorado State University, Fort Collins, CO, USA.,School of Biomedical Engineering, 3447Colorado State University, Fort Collins, CO, USA.,Mechanical Engineering, 3447Colorado State University, Fort Collins, CO, USA
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Margolis DS, Figueroa G, Barron Villalobos E, Smith JL, Doane CJ, Gonzales DA, Szivek JA. A Large Segmental Mid-Diaphyseal Femoral Defect Sheep Model: Surgical Technique. J INVEST SURG 2022; 35:1287-1295. [DOI: 10.1080/08941939.2022.2045393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- David S. Margolis
- Orthopedic Research Laboratory, College of Medicine, University of Arizona, Tucson, Arizona
| | - Gerardo Figueroa
- Orthopedic Research Laboratory, College of Medicine, University of Arizona, Tucson, Arizona
| | | | - Jordan L. Smith
- Orthopedic Research Laboratory, College of Medicine, University of Arizona, Tucson, Arizona
| | | | - David A. Gonzales
- Orthopedic Research Laboratory, College of Medicine, University of Arizona, Tucson, Arizona
| | - John A. Szivek
- Orthopedic Research Laboratory, College of Medicine, University of Arizona, Tucson, Arizona
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3D Biomimetic Porous Titanium (Ti 6Al 4V ELI) Scaffolds for Large Bone Critical Defect Reconstruction: An Experimental Study in Sheep. Animals (Basel) 2020; 10:ani10081389. [PMID: 32796533 PMCID: PMC7459697 DOI: 10.3390/ani10081389] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 01/10/2023] Open
Abstract
Simple Summary The authors propose a new reconstructive technique that proved to be suitable to reach this purpose through the use of a custom-made biomimetic porous titanium scaffold. An in vivo study was undertaken where a complete critical defect was experimentally created in the diaphysis of the right tibia of twelve sheep and replaced with a five-centimeter porous scaffold of electron beam melting (EBM)-manufactured titanium alloy or a porous hydroxyapatite scaffold. Our results show that EBM-formed titanium devices, if used to repair critical bone defects in a large animal model, can guarantee immediate body weight-bearing, a rapid functional recovery, and a good osseointegration. The porous hydroxyapatite scaffolds proved to be not suitable in this model of large bone defect due to their known poor mechanical properties. Abstract The main goal in the treatment of large bone defects is to guarantee a rapid loading of the affected limb. In this paper, the authors proposed a new reconstructive technique that proved to be suitable to reach this purpose through the use of a custom-made biomimetic porous titanium scaffold. An in vivo study was undertaken where a complete critical defect was experimentally created in the diaphysis of the right tibia of twelve sheep and replaced with a five-centimeter porous scaffold of electron beam melting (EBM)-sintered titanium alloy (EBM group n = 6) or a porous hydroxyapatite scaffold (CONTROL group, n = 6). After surgery, the sheep were allowed to move freely in the barns. The outcome was monitored for up to 12 months by periodical X-ray and clinical examination. All animals in the CONTROL group were euthanized for humane reasons within the first month after surgery due to the onset of plate bending due to mechanical overload. Nine months after surgery, X-ray imaging showed the complete integration of the titanium implant in the tibia diaphysis and remodeling of the periosteal callus, with a well-defined cortical bone. At 12 months, sheep were euthanized, and the tibia were harvested and subjected to histological analysis. This showed bone tissue formations with bone trabeculae bridging titanium trabeculae, evidencing an optimal tissue-metal interaction. Our results show that EBM-sintered titanium devices, if used to repair critical bone defects in a large animal model, can guarantee immediate body weight-bearing, a rapid functional recovery, and a good osseointegration. The porous hydroxyapatite scaffolds proved to be not suitable in this model of large bone defect due to their known poor mechanical properties.
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Veronesi F, Martini L, Giavaresi G, Fini M. Bone regenerative medicine: metatarsus defects in sheep to evaluate new therapeutic strategies for human long bone defect. A systematic review. Injury 2020; 51:1457-1467. [PMID: 32430197 DOI: 10.1016/j.injury.2020.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/01/2020] [Accepted: 04/08/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Large bone defects in long bone are not able to repair themselves and require grafts. Although autograft is the gold standard, it is associated with some disadvantages. Consequently, the application of tissue engineering (TE) techniques help with the use of allogenic biological and artificial scaffolds, cells and growth factors (GFs). Following 3Rs and in vitro testing strategies, animal models are required in preclinical in vivo studies to evaluate the therapeutic effects of the most promising TE techniques. MATERIALS AND METHODS A systematic review was performed from 2000 to 2019 to evaluate bone regeneration sheep metatarsus defects. RESULTS Eleven in vivo studies on sheep metatarsus defect were retrieved. The mid-diaphysis of metatarsus was the region most employed to perform critical size defects. Natural, synthetic and hybrid scaffolds were implanted, combined with bone marrow mesenchymal stem cells (BMSCs), GFs such as osteogenic protein 1 (OP1) and platelet rich plasma (PRP). The maximum follow-up period was 4 and 6 months in which radiography, histology, histomorphometry, computed tomography (CT) and biomechanics were performed to evaluate the healing status. CONCLUSIONS the sheep metatarsus defect model seems to be a suitable environment with a good marriage of biological and biomechanical properties. Defects of 3 cm are treated with natural scaffolds (homologous graft or allografts), those of 2.5 cm with natural, synthetic or composite scaffolds, while little defects (0.5 × 0.5 cm) with composite scaffolds. No difference in results is found regardless of the defect size.
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Affiliation(s)
- Francesca Veronesi
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Lucia Martini
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Gianluca Giavaresi
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136 Bologna, Italy.
| | - Milena Fini
- Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136 Bologna, Italy.
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Meng ZL, Wu ZQ, Shen BX, Li HB, Bian YY, Zeng DL, Fu J, Peng L. Reconstruction of large segmental bone defects in rabbit using the Masquelet technique with α-calcium sulfate hemihydrate. J Orthop Surg Res 2019; 14:192. [PMID: 31242906 PMCID: PMC6595676 DOI: 10.1186/s13018-019-1235-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/11/2019] [Indexed: 12/17/2022] Open
Abstract
Background Large segmental bone defects can be repaired using the Masquelet technique in conjunction with autologous cancellous bone (ACB). However, ACB harvesting is severely restricted. α-calcium sulfate hemihydrate (α-CSH) is an outstanding bone substitute due to its easy availability, excellent biocompatibility, biodegradability, and osteoconductivity. However, the resorption rate of α-CSH is too fast to match the rate of new bone formation. The objective of this study was to investigate the bone repair capacity of the Masquelet technique in conjunction with isolated α-CSH or an α-CSH/ACB mix in a rabbit critical-sized defect model. Methods The rabbits (n = 28) were randomized into four groups: sham, isolated α-CSH, α-CSH/ACB mix, and isolated ACB group. A 15-mm critical-sized defect was established in the left radius, followed by filling with polymethyl methacrylate spacer. Six weeks after the first operation, the spacers were removed and the membranous tubes were grafted with isolated α-CSH, isolated ACB, α-CSH/ACB mix, or none. Twelve weeks later, the outcomes were evaluated by manual assessment, radiography, and spiral-CT. The histopathological and morphological changes were examined by H&E staining. The levels of alkaline phosphatase and osteocalcin were analyzed by immunohistochemistry and immunofluorescence staining. Results Our results suggest that the bone repair capacity of the α-CSH/ACB mix group was similar to the isolated ACB group, while the isolated α-CSH group was significantly decreased compared to the isolated ACB group. Conclusion These results highlighted a promising strategy in the healing of large segmental bone defect with the Masquelet technique in conjunction with an α-CSH/ACB mix (1:1, w/w) as they possessed the combined effects of sufficient supply and low resorption.
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Affiliation(s)
- Zhu Long Meng
- Municipal Hospital Affiliated to Medical School of Taizhou University, Taizhou, China.,Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Zi Quan Wu
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Bi Xin Shen
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Hong Bo Li
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yang Yang Bian
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - De Lu Zeng
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jian Fu
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Lei Peng
- Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
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9
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Decambron A, Fournet A, Bensidhoum M, Manassero M, Sailhan F, Petite H, Logeart-Avramoglou D, Viateau V. Low-dose BMP-2 and MSC dual delivery onto coral scaffold for critical-size bone defect regeneration in sheep. J Orthop Res 2017; 35:2637-2645. [PMID: 28401593 DOI: 10.1002/jor.23577] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 04/06/2017] [Indexed: 02/04/2023]
Abstract
Tissue-engineered constructs (TECs) combining resorbable calcium-based scaffolds and mesenchymal stem cells (MSCs) have the capability to regenerate large bone defects. Inconsistent results have, however, been observed, with a lack of osteoinductivity as a possible cause of failure. This study aimed to evaluate the impact of the addition of low-dose bone morphogenetic protein-2 (BMP-2) to MSC-coral-TECs on the healing of clinically relevant segmental bone defects in sheep. Coral granules were either seeded with autologous MSCs (bone marrow-derived) or loaded with BMP-2. A 25-mm-long metatarsal bone defect was created and stabilized with a plate in 18 sheep. Defects were filled with one of the following TECs: (i) BMP (n = 5); (ii) MSC (n = 7); or (iii) MSC-BMP (n = 6). Radiographic follow-up was performed until animal sacrifice at 4 months. Bone formation and scaffold resorption were assessed by micro-CT and histological analysis. Bone union with nearly complete scaffold resorption was observed in 1/5, 2/7, and 3/6 animals, when BMP-, MSC-, and MSC-BMP-TECs were implanted, respectively. The amount of newly formed bone was not statistically different between groups: 1074 mm3 [970-2478 mm3 ], 1155 mm3 [970-2595 mm3 ], and 2343 mm3 [931-3276 mm3 ] for BMP-, MSC-, and MSC-BMP-TECs, respectively. Increased scaffold resorption rate using BMP-TECs was the only potential side effect observed. In conclusion, although the dual delivery of MSCs and BMP-2 onto a coral scaffold further increased bone formation and bone union when compared to single treatment, results were non-significant. Only 50% of the defects healed, demonstrating the need for further refinement of this strategy before clinical use. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2637-2645, 2017.
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Affiliation(s)
- Adeline Decambron
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France.,Ecole Nationale Vétérinaire d'Alfort (Université Paris-Est), 7 avenue du général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - Alexandre Fournet
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France.,Ecole Nationale Vétérinaire d'Alfort (Université Paris-Est), 7 avenue du général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - Morad Bensidhoum
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France
| | - Mathieu Manassero
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France.,Ecole Nationale Vétérinaire d'Alfort (Université Paris-Est), 7 avenue du général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - Frédéric Sailhan
- Hopital Cochin, Service d'orthopédie et chirurgie du rachis, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.,Clinique Arago, 187 Rue Raymond Losserand, 75014, Paris, France
| | - Hervé Petite
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France
| | - Delphine Logeart-Avramoglou
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France
| | - Véronique Viateau
- Laboratoire de Bioingénierie et Bioimagerie Ostéo-Articulaire (B2OA-UMR CNRS 7052) Université Paris Diderot, 10 Avenue de Verdun, 75010, Paris, France.,Ecole Nationale Vétérinaire d'Alfort (Université Paris-Est), 7 avenue du général de Gaulle, 94704, Maisons-Alfort Cedex, France
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Induced membrane technique: Advances in the management of bone defects. Int J Surg 2017; 42:110-116. [DOI: 10.1016/j.ijsu.2017.04.064] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 04/19/2017] [Accepted: 04/30/2017] [Indexed: 12/31/2022]
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Decambron A, Manassero M, Bensidhoum M, Lecuelle B, Logeart-Avramoglou D, Petite H, Viateau V. A comparative study of tissue-engineered constructs from Acropora and Porites coral in a large animal bone defect model. Bone Joint Res 2017; 6:208-215. [PMID: 28408376 PMCID: PMC5415902 DOI: 10.1302/2046-3758.64.bjr-2016-0236.r1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/17/2017] [Indexed: 01/27/2023] Open
Abstract
Objectives To compare the therapeutic potential of tissue-engineered constructs (TECs) combining mesenchymal stem cells (MSCs) and coral granules from either Acropora or Porites to repair large bone defects. Materials and Methods Bone marrow-derived, autologous MSCs were seeded on Acropora or Porites coral granules in a perfusion bioreactor. Acropora-TECs (n = 7), Porites-TECs (n = 6) and bone autografts (n = 2) were then implanted into 25 mm long metatarsal diaphyseal defects in sheep. Bimonthly radiographic follow-up was completed until killing four months post-operatively. Explants were subsequently processed for microCT and histology to assess bone formation and coral bioresorption. Statistical analyses comprised Mann-Whitney, t-test and Kruskal–Wallis tests. Data were expressed as mean and standard deviation. Results A two-fold increaseof newly formed bone volume was observed for Acropora-TECs when compared with Porites-TECs (14 sd 1089 mm3versus 782 sd 507 mm3; p = 0.09). Bone union was consistent with autograft (1960 sd 518 mm3). The kinetics of bioresorption and bioresorption rates at four months were different for Acropora-TECs and Porites-TECs (81% sd 5% versus 94% sd 6%; p = 0.04). In comparing the defects that healed with those that did not, we observed that, when major bioresorption of coral at two months occurs and a scaffold material bioresorption rate superior to 90% at four months is achieved, bone nonunion consistently occurred using coral-based TECs. Discussion Bone regeneration in critical-size defects could be obtained with full bioresorption of the scaffold using coral-based TECs in a large animal model. The superior performance of Acropora-TECs brings us closer to a clinical application, probably because of more suitable bioresorption kinetics. However, nonunion still occurred in nearly half of the bone defects. Cite this article: A. Decambron, M. Manassero, M. Bensidhoum, B. Lecuelle, D. Logeart-Avramoglou, H. Petite, V. Viateau. A comparative study of tissue-engineered constructs from Acropora and Porites coral in a large animal bone defect model. Bone Joint Res 2017;6:208–215. DOI: 10.1302/2046-3758.64.BJR-2016-0236.R1.
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Affiliation(s)
- A Decambron
- Laboratory of Bioengineering and Bioimaging for Osteo-Articular tissues (B2OA), 10 Avenue de Verdun, 75010 Paris and Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94704 Maisons-Alfort Cedex, France
| | - M Manassero
- Laboratory of Bioengineering and Bioimaging for Osteo-Articular tissues (B2OA), 10 Avenue de Verdun, 75010 Paris and Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94704 Maisons-Alfort Cedex, France
| | - M Bensidhoum
- Laboratory of Bioengineering and Bioimaging for Osteo-Articular tissues (B2OA), 10 Avenue de Verdun, 75010 Paris, France
| | - B Lecuelle
- Ecole Nationale Vétérinaire d'Alfort-Université Paris Est, 7 Avenue du Général de Gaulle, Maisons-Alfort 94704, France
| | - D Logeart-Avramoglou
- Laboratory of Bioengineering and Bioimaging for Osteo-Articular tissues (B2OA), 10 Avenue de Verdun, 75010 Paris, France
| | - H Petite
- Laboratory of Bioengineering and Bioimaging for Osteo-Articular tissues (B2OA), 10 Avenue de Verdun, 75010 Paris, France
| | - V Viateau
- Laboratory of Bioengineering and Bioimaging for Osteo-Articular tissues (B2OA), 10 Avenue de Verdun, 75010 Paris and Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94704 Maisons-Alfort Cedex, France
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Marcondes G, Nóbrega F, Corrêa L, Chavez VA, Plepis A, Martins V, Zoppa A. Avaliação da interação biológica entre compósito de quitosana, colágeno e hidroxiapatita e tecido ósseo ovino. ARQ BRAS MED VET ZOO 2016. [DOI: 10.1590/1678-4162-8824] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO As lesões em membros de grandes animais são um desafio para médicos veterinários, uma vez que somente a osteossíntese não garante resultados satisfatórios. Muitos pesquisadores vêm se dedicando ao desenvolvimento e estudo de substitutos ósseos produzidos de materiais naturais, como quitosana, colágeno e hidroxiapatita, que auxiliam na regeneração óssea. Seis ovinos fêmeas da raça Santa Inês foram submetidos a ostectomias unicorticais de sete milímetros de diâmetro na região proximal da superfície dorsomedial dos III/IV metacarpianos. Foi implantado compósito de quitosana, colágeno e hidroxiapatita em um membro torácico para avaliação da biocompatibilidade do material ao tecido ósseo ovino, e no membro contralateral foi reproduzida a mesma técnica, porém foi mantido sem preenchimento, como controle. Após 60 dias do procedimento cirúrgico, realizou-se biópsia óssea na área de interface entre biomaterial/osso (membro com compósito) e tecido neoformado/osso (membro controle), para realização de avaliação histológica do material não descalcificado, por meio de microscopia de luz e microscopia eletrônica de varredura. Na análise histomorfométrica, mediante microscopia de luz, foi possível identificar maior porcentagem de tecido neoformado em membro controle, quando comparado ao membro com compósito (80% e 63,5%, respectivamente; P<0,05). Por meio da microscopia eletrônica de varredura, observou-se invasão da estrutura interna do compósito por tecido ósseo neoformado. Não houve formação de tecido cicatricial, reação de corpo estranho ou resposta inflamatória crônica nas amostras analisadas. Conclui-se que o compósito de quitosana, colágeno e hidroxiapatita, quando implantado em tecido ósseo ovino, apresenta biocompatibilidade e perfil osteocondutor.
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Influence of a titanium mesh on the management of segmental long bone defects. An experimental study in a canine ulnar model. Vet Comp Orthop Traumatol 2015; 28:417-24. [PMID: 26449275 DOI: 10.3415/vcot-14-11-0173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 07/23/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the influence of titanium mesh on guided bone regeneration when used, either alone or in combination with autogenous bone block graft, in a canine ulnar model. METHODS Thirty-two, purpose bred, adult, castrated male Beagles were used, divided into four equal-size groups. A unilateral mid-diaphyseal ulnar critical-size defect was created in each dog. The ulnar segments were stabilized with a stainless-steel plate and screws. Each defect was managed by: no further treatment (Group A) or by placement of a bone block graft taken from the ipsilateral iliac crest (Group B), or titanium mesh wrapped around the ulna (Group C), or a bone block graft and titanium mesh (Group D). After six months, bone block biopsies were performed and the samples were scanned using micro-computed tomography. Qualitative histological evaluation was performed on two non-decalcified longitudinal sections from each block. RESULTS No significant differences in terms of mineralized bone volume were detected between the grafted sites (Groups B and D) or between the non-grafted ones (Groups A and C). The histological evaluation indicated good integration of the bone blocks irrespective of the use of titanium mesh. CLINICAL SIGNIFICANCE The use of titanium mesh does not influence the amount of bone formation. The canine ulnar critical-size defect model seems to be a reliable model to use in experimental studies.
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de Monès E, Schlaubitz S, Oliveira H, d'Elbée JM, Bareille R, Bourget C, Couraud L, Fricain JC. Comparative study of membranes induced by PMMA or silicone in rats, and influence of external radiotherapy. Acta Biomater 2015; 19:119-27. [PMID: 25770925 DOI: 10.1016/j.actbio.2015.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 02/27/2015] [Accepted: 03/05/2015] [Indexed: 12/11/2022]
Abstract
The induced membrane technique has been used for long bone defect reconstruction after traumatism. One of the major drawbacks of this method is the difficult removal of the polymethyl methacrylate spacer after membrane formation. We therefore replaced the stiff PMMA spacer with a semi-flexible medical grade silicone spacer. This study aimed to compare subcutaneously formed membranes, induced by PMMA and silicone, in the irradiated or not irradiated areas within 28 rats that received the spacers. Histological analysis was performed to evaluate the composition of the membrane and to quantify the amount of vessels. Histomorphometric measurements were used to evaluate membranes' thickness, while fibrosis and inflammation were scored. The expression of VEGF and BMP-2 in lysates of the crushed membranes was determined by Western blotting. ALP expression was analyzed in HBMSC cultures in contact with the same lysates. Non-irradiated membranes induced by the two spacer types were non-inflammatory, fibrous and organized in layers. Irradiation did not change the macroscopic properties of membranes that were induced by silicone, while PMMA induced membranes were sensitive to the radiotherapy, resulting in thicker, strongly inflammatory membranes. Irradiated membranes showed an overall reduced osteogenic potential. Medical grade silicone is safe for the use in radiotherapy and might therefore be of great advantage for patients in need of cancer treatment.
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Affiliation(s)
- Erwan de Monès
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Department of Otolaryngology - Head and Neck Surgery, Univ. Bordeaux, Place Amélie Raba Léon, F-33000 Bordeaux, France
| | - Silke Schlaubitz
- Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Bordeaux University Hospital, CIC 1401, PTIB, Xavier Arnozan Hospital, Avenue Haut Lévêque, F-33000 Bordeaux, France
| | - Hugo Oliveira
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France
| | - Jean-Marie d'Elbée
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France
| | - Reine Bareille
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France
| | - Chantal Bourget
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France
| | - Lionel Couraud
- Bordeaux University Hospital, CIC 1401, PTIB, Xavier Arnozan Hospital, Avenue Haut Lévêque, F-33000 Bordeaux, France
| | - Jean-Christophe Fricain
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Univ. Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Department of Dentistry, Univ. Bordeaux, Place Amélie Raba Léon, F-33000 Bordeaux, France.
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Marais LC, Ferreira N. Bone transport through an induced membrane in the management of tibial bone defects resulting from chronic osteomyelitis. Strategies Trauma Limb Reconstr 2015; 10:27-33. [PMID: 25840909 PMCID: PMC4395567 DOI: 10.1007/s11751-015-0221-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 03/29/2015] [Indexed: 02/07/2023] Open
Abstract
Wide resection of infected bone improves the odds of achieving remission of infection in patients with chronic osteomyelitis. Aggressive debridement is followed by the creation of large bone defects. The use of antibiotic-impregnated PMMA spacers, as a customized dead space management tool, has grown in popularity. In addition to certain biological advantages, the spacer offers a therapeutic benefit by serving as a vehicle for delivery of local adjuvant antibiotics. In this study, we investigate the efficacy of physician-directed antibiotic-impregnated PMMA spacers in achieving remission of chronic tibial osteomyelitis. This retrospective case series involves eight patients with chronic osteomyelitis of the tibial diaphysis managed with bone transport through an induced membrane using circular external fixation. All patients were treated according to a standardized treatment protocol. A review of the anatomical nature of the disease, the physiological status of the host and the outcome of treatment in terms of remission of infection, time to union and the complications that occurred was carried out. Seven patients, with a mean bone defect of 7 cm (range 5-8 cm), were included in the study. At a mean follow-up of 28 months (range 18-45 months), clinical eradication of osteomyelitis was achieved in all patients without the need for further reoperation. The mean total external fixation time was 77 weeks (range 52-104 weeks), which equated to a mean external fixation index of 81 days/cm (range 45-107). Failure of the skeletal reconstruction occurred in one patient who was not prepared to continue with further reconstructive surgery and requested amputation. Four major and four minor complications occurred. The temporary insertion of antibiotic-impregnated PMMA appears to be a useful dead space management technique in the treatment of post-infective tibial bone defects. Although the technique does not appear to offer an advantage in terms of the external fixation index, it may serve as a useful adjunct in order to achieve resolution of infection.
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Affiliation(s)
- Leonard Charles Marais
- Tumor, Sepsis and Reconstruction Unit, Department of Orthopaedic Surgery, Greys Hospital, University of KwaZulu-Natal, Private bag X9001, Pietermaritzburg, 3201, South Africa,
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Salvianolic acid B promotes bone formation by increasing activity of alkaline phosphatase in a rat tibia fracture model: a pilot study. Altern Ther Health Med 2014; 14:493. [PMID: 25510675 PMCID: PMC4301899 DOI: 10.1186/1472-6882-14-493] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 12/10/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Radix Salviae miltiorrhizae is a herb frequently used within traditional Chinese medicine for the treatment of cardiovascular- and trauma-related diseases. Danshen is the dried root of Salviae miltiorrhizae, from which the polyphenolic compound Salvianolic acid B (Sal B) can be obtained. Sal B is a key component of Danshen. The aim of this study was to determine the effect of Sal B on the healing of long bones following trauma in a rat tibia fracture model. METHODS Tibia fractures were created in 20 male Sprague Dawley rats. The animals were divided into two groups: (1) experimental group (n = 10); and (2) control group (n = 10). Rats in the experimental group were intraperitoneally administered with Sal B (40 mg/kg/d) for 3 weeks, while rats in the control group received an identical volume of physiological saline solution, administered in the same way. X-ray photographs were taken of all animals at the time points. Rats were euthanized at weeks 1, 3, 8 and 12 post-fracture. Fracture calluses were measured and callus sections were obtained and stained using hematoxylin and eosin (HE) and the calcium cobalt method. HE stained sections were observed and evaluated according to different grades of bone remodeling. Sections stained using the calcium cobalt method were analyzed with an imagine analysis system. RESULTS Data showed that callus growth was significantly greater in the experimental group compared with the control group (P < 0.05). Furthermore, histological scores in the Sal B-treated group were statistically higher than in the saline treated group at weeks 1, 3 and 8 post-fracture (P < 0.05). Alkaline phosphatase (ALP) activity was enhanced in the experimental group at weeks 1 and 3 post-fracture (P < 0.05). CONCLUSIONS Our results suggest that Sal B may accelerate early-stage fracture healing. Increased activity of ALP may be one factor which promotes the healing process. This pilot study provides brief insight into the effect of Sal B in fracture healing. These findings will contribute to the development of more and enhanced treatment options for trauma fracture patients.
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Viateau V, Decambron A, Manassero M. Animal Models for Orthopedic Applications of Tissue Engineering. Biomaterials 2014. [DOI: 10.1002/9781119043553.ch8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Reichert JC, Berner A, Saifzadeh S, Hutmacher DW. Preclinical Animal Models for Segmental Bone Defect Research and Tissue Engineering. Regen Med 2013. [DOI: 10.1007/978-94-007-5690-8_40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Healing of long-bone defects in sheep metatarsals using bioceramics and mesenchymal stem cells. CURRENT ORTHOPAEDIC PRACTICE 2012. [DOI: 10.1097/bco.0b013e318259e847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Multiple surgeries are often required to manage segmental bone loss because of the complex mechanics and biology involved in reconstruction. These procedures can lead to prolonged recovery times, poor patient outcomes, and even delayed amputation. A two-stage technique uses induced biologic membranes with delayed placement of bone graft to manage this clinical challenge. In the first stage, a polymethyl methacrylate spacer is placed in the defect to produce a bioactive membrane, which appears to mature biochemically and physically 4 to 8 weeks after spacer placement. In the second, cancellous autograft is placed within this membrane and, via elution of several growth factors, the membrane appears to prevent graft resorption and promote revascularization and consolidation of new bone. Excellent clinical results have been reported, with successful reconstruction of segmental bone defects >20 cm.
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Hahn JA, Witte TS, Arens D, Pearce A, Pearce S. Double-plating of ovine critical sized defects of the tibia: a low morbidity model enabling continuous in vivo monitoring of bone healing. BMC Musculoskelet Disord 2011; 12:214. [PMID: 21958221 PMCID: PMC3195802 DOI: 10.1186/1471-2474-12-214] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 09/29/2011] [Indexed: 11/23/2022] Open
Abstract
Background Recent studies using sheep critical sized defect models to test tissue engineered products report high morbidity and complications rates. This study evaluates a large bone defect model in the sheep tibia, stabilized with two, a novel Carbon fibre Poly-ether-ether-ketone (CF-PEEK) and a locking compression plate (LCP) which could sustain duration for up to 6 month with an acceptable low complication rate. Methods A large bone defect of 3 cm was performed in the mid diaphysis of the right tibia in 33 sheep. The defect was stabilised with the CF - PEEK plate and an LCP. All sheep were supported with slings for 8 weeks after surgery. The study was carried out for 3 months in 6 and for 6 months in 27 animals. Results The surgical procedure could easily be performed in all sheep and continuous in vivo radiographic evaluation of the defect was possible. This long bone critical sized defect model shows with 6.1% a low rate of complications compared with numbers mentioned in the literature. Conclusions This experimental animal model could serve as a standard model in comparative research. A well defined standard model would reduce the number of experimental animals needed in future studies and would therefore add to ethical considerations.
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Preclinical Animal Models for Segmental Bone Defect Research and Tissue Engineering. Regen Med 2011. [DOI: 10.1007/978-90-481-9075-1_36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Di Bella C, Aldini NN, Lucarelli E, Dozza B, Frisoni T, Martini L, Fini M, Donati D. Osteogenic protein-1 associated with mesenchymal stem cells promote bone allograft integration. Tissue Eng Part A 2010; 16:2967-76. [PMID: 20533882 DOI: 10.1089/ten.tea.2009.0637] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Limited incorporation and modest bone remodeling can cause allograft failure. We investigated whether mesenchymal stem cells (MSCs) and osteogenic protein-1 (OP-1) can improve allograft integration. A 3-cm full-size intercalary bone defect was created in the mid-diaphysis of the metatarsal bone of the sheep and it was replaced with an allograft alone (control group), or with MSCs (MSC group), OP-1 (OP-1 group), or MSCs and OP-1 (MSC + OP-1 group). Radiographic results showed a faster and complete integration of the allograft in the MSC + OP-1 group. Histology demonstrated that the amount of new bone was significantly greater inside the graft and a longer vessel penetration in the MSC + OP-1 group than in others. Mechanical strength of the allograft was not compromised by the high rate of bone remodeling. These results demonstrated that the association of MSCs and OP-1 improve bone allograft integration promoting an almost complete bone restoring.
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Affiliation(s)
- Claudia Di Bella
- Bone Regeneration Laboratory, Department of Muskulo-Skeletal Oncology, Research Institute Codivilla-Putti, Rizzoli Orthopaedic Institute, Bologna, Italy.
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van Gaalen SM, Dhert WJA, Kruyt MC, Yuan H, Oner FC, van Blitterswijk CA, Verbout AJ, de Bruijn JD. Goat bone tissue engineering: comparing an intramuscular with a posterolateral lumbar spine location. Tissue Eng Part A 2010; 16:685-93. [PMID: 19769525 DOI: 10.1089/ten.tea.2009.0073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to investigate the effect of implant location on bone formation in goats using autologous bone marrow-derived stromal cells in porous calcium phosphate scaffolds. Intramuscular locations were compared to posterolateral spine fusion locations in eight goats. As scaffolds, we used biphasic calcium phosphate porous blocks of 5 x 5 x 5 mm. Cell-seeded implants were compared to empty controls. Bone marrow-derived stromal cells were seeded at 8 million cells per cm(3) scaffold and cultured for 1 week. The follow-up time was 12 weeks. Fluorochromes were administered intravenously at 4, 6, and 8 weeks. Ectopic implants showed 21 +/- 3.6% bone formation for the cell seeded and 2.0 +/- 3.0% for the controls (p < 0.001). Paraspinal implants, however, showed 0.10 +/- 0.13% in the cell seeded compared to 0.023 +/- 0.027% in the control group (p = 0.09). A benefit of the cells was only found in the area closest to the paraspinal muscles (p < 0.01). Bone formation in the control samples was of later onset compared to the cell-seeded implants. In conclusion, cell-based bone tissue engineering in an ectopic environment was clearly effective. Similar constructs implanted in a posterolateral spine fusion location hardly showed any effect.
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Affiliation(s)
- Steven M van Gaalen
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
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Viateau V, Bensidhoum M, Guillemin G, Petite H, Hannouche D, Anagnostou F, Pélissier P. Use of the induced membrane technique for bone tissue engineering purposes: animal studies. Orthop Clin North Am 2010; 41:49-56; table of contents. [PMID: 19931052 DOI: 10.1016/j.ocl.2009.07.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Animal experiments using the induced membrane procedure for bone tissue engineering purposes have provided evidence that the membrane has structural characteristics and biologic properties that may be used for bone tissue engineering purposes. Clinically relevant animal models have demonstrated that standardized particulate bone constructs can be used to repair large bone defects using the procedure and that the osteogenic ability of these constructs partially approaches that of bone autografts.
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Affiliation(s)
- Véronique Viateau
- Unité Pédagogique de Pathologie Chirurgicale, Ecole vétérinaire d'Alfort, 94700 Maisons-Alfort, France.
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Wingerter S, Calvert G, Tucci M, Tsao A, Russell G, Benghuzzi H. Comparison of Two Different Fixation Techniques for a Segmental Defect in a Rat Femur Model. J INVEST SURG 2009; 20:149-55. [PMID: 17613689 DOI: 10.1080/08941930701364732] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Studies have attempted to identify the osteogenic effects of bone morphogenetic proteins using a rat femur model, which commonly involves the creation of a critical size defect followed by internal fixation of the femur. Among the most familiar fixation methods are either plating or intramedullary placement of a Kirschner wire (K-wire). There are advantages and disadvantages to each method; however, this study attempts to identify the best method by exploring the histological effects of each technique. The experiment involved two groups with no added treatment: Group P (plate fixation method) and Group K (K-wire fixation method). The animals were allowed a 4-week interval for the femurs to heal, and proximal, distal, and two midshaft cuts were examined under high-power microscopy after the fixation apparatus was removed. Group K exhibited a peculiar fibrotic healing pattern that followed the shaft of the then vacated K-wire and there was minimal new viable bone formation. Group P, however, exhibited a more natural ingrowth of newly formed bone that began at the proximal and distal cuts and proceeded centrally into the core of the defect. Due to the fibrotic tissue in Group K, this study shows that the model is insufficient due to the micromotion created and thus supports plating of critical defects as the fixation method of choice due to the creation of a stable healing environment.
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Affiliation(s)
- Scott Wingerter
- Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA
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Viateau V, Guillemin G, Bousson V, Oudina K, Hannouche D, Sedel L, Logeart-Avramoglou D, Petite H. Long-bone critical-size defects treated with tissue-engineered grafts: a study on sheep. J Orthop Res 2007; 25:741-9. [PMID: 17318898 DOI: 10.1002/jor.20352] [Citation(s) in RCA: 164] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Standardized particulate bone constructs, obtained by expanding autologous mesenchymal stem cells (MSCs) onto coral granules in vitro, were transplanted into long-bone, critical-size defects in sheep. Control experiments were also performed in which autologous bone grafts were implanted. Defect cavities were lined with a preformed vascularized membrane (induced by temporarily inserting a cement spacer for 6 weeks prior to bone construct implantation), which served as a mold keeping the engineered bone granules in place. Radiographic, histological, and computed tomographic tests performed 6 months later showed that the osteogenic abilities of the engineered construct and autograft were significantly greater than those of coral scaffold alone. No significant differences were found between the amount of newly formed bone in defects filled with coral/MSCs and those filled with autograft, yet radiological scores differed significantly between the two groups (21% and 100% healed cortices, respectively). The present study on a clinically relevant animal model provides the first evidence that standardized particulate bone constructs can be used to repair large bone defects and that their osteogenic ability approaches that of bone autograft, the bone repair benchmark. By proving feasibility, the present study makes possible the treatment of segmental bone losses with bone constructs engineered from granules, a process which is much simpler than preparing customized massive constructs using computer-assisted techniques. Important parameters, such as the rate of scaffold resorption and the number of MSCs to be seeded on the scaffolds, need to be optimized before reaching pertinent definitive conclusions.
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Affiliation(s)
- Véronique Viateau
- Ecole Nationale Vétérinaire d'Alfort, 7 avenue de Gaulle, 94700 Maisons Alfort, France
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Viateau V, Guillemin G, Calando Y, Logeart D, Oudina K, Sedel L, Hannouche D, Bousson V, Petite H. Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects: an ovine model. Vet Surg 2006; 35:445-52. [PMID: 16842289 DOI: 10.1111/j.1532-950x.2006.00173.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To report an ovine model that can be used to evaluate the efficacy of bone substitutes for repair of segmental diaphyseal bone defects. STUDY DESIGN Experimental study. ANIMALS Eleven 2-year-old Pré-Alpes Sheep. METHODS Mid-diaphyseal metatarsal bone defects (25 mm long) were stabilized by a dynamic compression plate over a polymethylmethacrylate (PMMA) cement spacer, and by external coaptation. The PMMA spacer was removed at 6 weeks by incising the encapsulating membrane. The defect remained unfilled (Group 1; n=5) or was filled with morselized autologous corticocancellous graft (Group 2; n=6), the membrane sutured closed, and external coaptation applied for 6 months, when healing was evaluated. RESULTS Radiographic, computed tomographic, and histologic examinations at 6 months after the 2nd surgery revealed non-union in ungrafted defects whereas grafted defects showed bone healing. The induced membrane had blood vessels, CBFA1+ cells, and very few macrophages entrapped in a collagenous tissue positive for type I collagen. CONCLUSION This ovine metatarsal defect model resulted in a critical-size defect (non-union) that healed when grafted. The PMMA-induced membrane constrained the graft, was well vascularized, and may have osteogenic properties. CLINICAL RELEVANCE This model may be useful to evaluate new strategies in bone tissue engineering because the PMMA-induced membrane may help confine bone morphogenetic proteins, skeletal stem cells, or other agents to the defect cavity where they could be useful to enhance bone formation.
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Affiliation(s)
- Véronique Viateau
- Unité Pédagogique de Pathologie Chirurgicale, Ecole Nationale Vétérinaire d'Alfort, Paris, France
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Braddock M. Euroconference on tissue repair and ulcer/wound healing: molecular mechanisms, therapeutic targets and future directions. Expert Opin Investig Drugs 2006; 14:743-9. [PMID: 16004601 DOI: 10.1517/13543784.14.6.743] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The meeting was part of the Euroconference series organised at the Pasteur Institute in Paris. Comprising delegates from both academia and industry, it drew on expertise from many aspects of tissue repair in a wide range of human disease. The principal component of this report concerns progress with the therapeutic application of biological agents in promoting tissue repair, as gene therapeutics, monoclonal antibodies and therapeutic proteins. In addition, the effect of pioglitazone on the rate and quality of wound healing in diabetic rats is also reported.
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Affiliation(s)
- Martin Braddock
- Discovery Bioscience, AstraZeneca R&D Charnwood, Bakewell Road, Loughborough, Leicestershire, LE11 5RH, UK.
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