Biological and Mechanical Enhancement of Impacted Allograft Seeded with Human Bone Marrow Stromal Cells: Potential Clinical Role in Impaction Bone Grafting

Abstract

With the demographics of an aging population the incidence of revision surgery is rapidly increasing. Clinical imperatives to augment skeletal tissue loss have brought mesenchymal stem cells to the fore in combination with the emerging discipline of tissue engineering. Impaction bone grafting for revision hip surgery is a recognized technique to reconstitute bone, the success of which relies on a combination of mechanical and biological factors. The use of morsellized allograft is currently the accepted clinical standard providing a good mechanical scaffold with little osteoinductive biological potential. We propose that applying the principles of a tissue engineering paradigm, the combination of human bone marrow stromal cells (hBMSCs) with allograft to produce a living composite, offers a biological and mechanical advantage over the current gold standard of allograft alone. This study demonstrates that hBMSCs combined with allograft can withstand the forces equivalent to a standard femoral impaction and continue to differentiate and proliferate along the bony lineage. In addition, the living composite provides a biomechanical advantage, with increased interparticulate cohesion and shear strength when compared with allograft alone.

Skeletal stem cell and bone implant interactions are enhanced by LASER titanium modification

“…180 Ti rods were cut into 8mm diameter by 2 mm long cylinders, and the surfaces of 90 discs were modified by LASER beam as described previously [6,11,18]. All samples were sterilized by ethylene oxide.…”

“…Analysis of hSSC 1 proliferation and viability cell number was determined using a standard DNA PicoGreen assay [18]. Cell lysate was measured for DNA content using qRT-PCR was performed using a 96-well optical reaction plate and a 7500 Real Time PCR system (Applied Biosystems, Carlsbad, USA).…”

Freeze‐dried human serum albumin improves the adherence and proliferation of mesenchymal stem cells on mineralized human bone allografts

“…2,3 One explanation can be that colonization of the graft by stem cells is too slow and falls below the threshold for bone remodeling. [4][5][6] The ideal bone graft can be characterized by good mechanical strength, osteoinductive, osteoconductive, and osteogenic capabilities and only the autologous human bone graft possesses all of the mentioned properties. 7 The unique bone healing potential of autologous bone graft stems from its three well-defined features: (a) osteoconductivity is provided by the structure of native bone, (b) osteoinductivity is given by morphogenetic proteins and other growth factors, and (c) osteogenicity is provided by cells, like osteoblasts, osteoclasts, and mesenchymal stem cells (MSCs) which are on the surface of a freshly harvested autologous bone graft.…”

Influence of Freeze-Drying and Irradiation on Mechanical Properties of Human Cancellous Bone: Application to Impaction Bone Grafting

“…On the other hand, graft stickiness was advocated to increase interparticulate cohesion (104). The combination of human bone marrow stromal cells with washed allograft to produce a living composite, offered a biological and mechanical advantage over the current gold standard of allograft alone and provided a higher shear strength when compared with allograft alone (105).…”