Can Mesenchymal Stem Cells Survive Under Normal Impaction Force in Revision Total Hip Replacements?

Korda, Michelle; Blunn, Gordon; Phipps, K.; Rust, Philippa A; Silvio, L. Di; Coathup, Melanie; Goodship, Allen E.; Hua, Jia

doi:10.1089/ten.2006.12.ft-47

Cited by 4 publications

(7 citation statements)

References 20 publications

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“…In vitro MSCs have been shown to survive impaction forces of up to 6 kN, with full recovery within 6 days. 8 For this study, the impactor was calibrated to 2.5 cm weight drop (3 kN) and 20 impactions were performed (Fig. 1).…”

Section: Impactionmentioning

confidence: 99%

“…In this study we use an ovine model of ectopic bone formation where bone graft substitute materials and allograft are combined with autologous MSCs to determine the osseoinductive potential of these combinations. Importantly, in this model we have impacted the bone graft materials with MSCs before implantation and have used impact forces similar to those used during revision hip surgery 8 that does initially decrease the metabolic activity of these stromal cells, and this may effect bone formation. We hypothesize that by combining allograft and mixtures of allograft and bone graft substitute materials with autologous MSCs and autologous OPs in impaction grafts, we will be able to induce osseoinductivity of these materials in an ectopic site.…”

Section: Introductionmentioning

confidence: 99%

“…These forces were quantified, and an impaction device was constructed to reproduce these forces. 8,25 Using this impactor, sheep MSCs were shown to survive the forces of impaction in vitro. 8 Previously, studies using animal models have shown that MSCs are osseoinductive.…”

mentioning

confidence: 99%

“…8,25 Using this impactor, sheep MSCs were shown to survive the forces of impaction in vitro. 8 Previously, studies using animal models have shown that MSCs are osseoinductive. In 2000, Kon et al described a pilot study using two sheep.…”

mentioning

confidence: 99%

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The Effect of Mesenchymal Stromal Cells on the Osseoinduction of Impaction Grafts

Korda¹,

Hua²,

Little

et al. 2010

Tissue Engineering Part A

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Revision total hip replacement has a failure rate of up to 25%. Part of the reason for this high failure is the lack of bone stock. In this study, we investigated whether mesenchymal stromal cells (MSCs) or osteoprogenitors (OPs) contribute to bone formation in impacted allograft or an allograft and hydroxyapatite (HA) combination. Eight samples were inserted in the paraspinal muscles of six sheep, which were allograft or an HA/allograft mix, seeded with autologous MSCs, autologous OPs, or no cells (control), and impacted with a clinically relevant force at 3 kN preimplantation. Other groups were HA blocks seeded with or without MSCs. Samples were retrieved at 12 weeks. MSCs incorporated into allograft, HA/allograft, and HA blocks displayed higher mean values of new bone formation compared with the controls, but there was no statistical difference between allograft groups. However, in HA/allograft groups, significantly more new bone was found with MSCs than without cells (p = 0.046) or with OPs (p = 0.028). In the HA blocks, more new bone was found in the MSC group than in the HA block without cells (p = 0.028). In conclusion, MSCs used with combinations of allograft and HA enhance new bone formation in an ovine ectopic site after being subjected to realistic forces that are used during impaction grafting.

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Section: Impactionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Effect of Mesenchymal Stromal Cells on the Osseoinduction of Impaction Grafts

Korda¹,

Hua²,

Little

et al. 2010

Tissue Engineering Part A

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“…In the absence of absolute confirmation that the addition of SSCs has resulted in this outcome, further clinical trials are necessary, including comparison to current therapies. However, referral can be made to extensive in vitro and in vivo work regarding SSC augmentation of bone regeneration on IBG (Bolland et al ., ; Burwell, ; Arthur et al ., ; Korda et al ., , ).…”

Section: Discussionmentioning

confidence: 99%

From bench to clinic and back: skeletal stem cells and impaction bone grafting for regeneration of bone defects

Aarvold

Smith

Tayton

et al. 2012

J Tissue Eng Regen Med

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Tissue engineering offers enormous potential for bone regeneration. Despite extensive in vitro and in vivo work, few strategies translate into clinical practice. This paper describes the combination of skeletal stem cells (SSCs) and impaction bone grafting (IBG) for the treatment of patients with bone defects associated with avascular necrosis of the femoral head. SSCs and milled allograft were impacted into necrotic bone in the femoral heads of four patients. Three patients remained asymptomatic at 22-44 month follow-up, but one patient has required total hip replacement (both hips). This has allowed retrieval of the femoral heads, which were analysed structurally and functionally by μCT, histology and mechanical testing. A central channel of impacted bone was found in the femoral heads, which displayed a mature trabecular micro-architecture. The impacted bone was denser than the surrounding trabecular bone, as strong in compression and with histological micro-architecture comparable to that of trabecular bone. Analysis of the retrieved femoral head samples has demonstrated that this tissue-engineering strategy regenerates bone that is both structurally and functionally analogous to normal trabecular bone. SSCs, together with IBG, have proved an effective treatment for avascular necrosis of the femoral head and offer significant potential for the broader spectrum of bone defects.

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An analysis of polymer type and chain length for use as a biological composite graft extender in impaction bone grafting: A mechanical and biocompatibility study

Tayton

Fahmy

Purcell

et al. 2012

J Biomedical Materials Res

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Impaction bone grafting (IBG) with human allograft remains the preferred approach for replacement of lost bone stock during revision hip surgery. Associated problems include cost, disease transmission, and stem subsidence. Synthetic grafts are therefore appealing, and ideally display similar mechanical characteristics as allograft, but with enhanced ability to form de novo bone. High and low molecular weight forms of three different polymers [poly(DL-lactide) (P(DL) LA), poly(DL-lactide-co-glycolide) (P(DL) LGA), and poly(ε-caprolactone) (PCL)] were milled, impacted into discs, and then examined in a shear testing rig, in comparison to allograft. In addition, skeletal stem cells (SSCs) were combined with each of the milled polymers, followed by impaction and examination for cell viability and number, via fluorostaining and biochemical assays. The shear strengths of high/low mwt P(DL) LA, and high/low mwt P(DL) LGA were significantly higher than allograft (p < 0.01). High/low mwt PCL had significantly lower shear strengths (p < 0.01). WST-1 assay and fluorstaining indicated significantly increased cell viability on high mwt P(DL) LA and high mwt P(DL) LGA over allograft (p < 0.05). Mechanical and biochemical analysis indicated improved properties of high mwt P(DL) LA and high mwt P(DL) LGA over allograft. This study indicates the potential of these polymers for use as substitute human allograft, creating a living composition with SSC for application in IBG.

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Can Mesenchymal Stem Cells Survive Under Normal Impaction Force in Revision Total Hip Replacements?

Cited by 4 publications

References 20 publications

The Effect of Mesenchymal Stromal Cells on the Osseoinduction of Impaction Grafts

The Effect of Mesenchymal Stromal Cells on the Osseoinduction of Impaction Grafts

From bench to clinic and back: skeletal stem cells and impaction bone grafting for regeneration of bone defects

An analysis of polymer type and chain length for use as a biological composite graft extender in impaction bone grafting: A mechanical and biocompatibility study

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