Osteogenic enhancement of diaphyseal reconstruction: Comparison of bone grafts in the rabbit

Köhler, Peter; Ehrnberg, Anders; Kreicbergs, Andris

doi:10.3109/17453679008993064

Cited by 8 publications

(15 citation statements)

References 5 publications

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“…Dog, rabbit, and cat models have been used to examine repair of critical-size bone defects using various types of bone grafts. [50][51][52][53][54][55][56][57] Large animal models are extremely valuable because they offer the best simulation of the clinical situation. However, these models have two major shortcomings.…”

Section: Direct Gene Therapy Approaches For Bone Repairmentioning

confidence: 99%

Direct Gene Therapy for Bone Regeneration: Gene Delivery, Animal Models, and Outcome Measures

Pelled

Ben-Arav

Hock

et al. 2010

Tissue Engineering Part B: Reviews

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Section: Direct Gene Therapy Approaches For Bone Repairmentioning

confidence: 99%

Direct Gene Therapy for Bone Regeneration: Gene Delivery, Animal Models, and Outcome Measures

Pelled

Ben-Arav

Hock

et al. 2010

Tissue Engineering Part B: Reviews

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“…It was hypothesized that the biological success of a mineralized bone allograft might be enhanced by surrounding it with osteoinductive bone material. Also, Kohler and Kreicbergs (1987) and Kohler et al (1990) reported that DBM supplements improved the osteogenicity of autoclaved autografts and frozen allografts in rabbit ulnae and humeri. Clinically, it has been suggested that patients with bone defects greater than 4 to 6 cm have been considered poor candidates for cancellous bone grafting because of the high rate of refracture and non-union (Enneking et al, 1980;Moore et al, 1983;Goldstrohm et al, 1984).…”

Section: Resultsmentioning

confidence: 96%

The Effect of Demineralized Bone Matrix on the Healing of Intramembranous Bone Grafts in Rabbit Skull Defects

et al. 1996

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A clinical dilemma exists regarding the type of bone that should be used to replace diseased or traumatized osseous tissue. Oral, plastic, and orthopedic surgeons normally implant viable mineralized endochondral (EC) autografts or demineralized EC allografts. A few clinicians have recognized the disadvantages of using EC bone in craniofacial surgery and advocated the replacement of intramembranous (IM) bone with healthy IM bone. However, controversy and uncertainty surround our understanding of these matrices to induce bone formation. Recent studies have advocated the use of other materials with osteoinductive properties, such as demineralized bone matrix (DBM). The proposed delivery system used in this study included IM bone grafts, DBM, and fixation of the IM bone graft. The purpose of this work was to gain further insights into the mechanism of healing of IM bone, in both the presence and the absence of DBM, and to compare the healing of IM bone grafts with that of DBM alone. Critical-sized (10 x 5 mm), full-thickness bony defects in rabbit parietal bone, devoid of periosteum, were filled with IM bone graft (mandible) alone, demineralized cortical bone matrix (DBM) alone, or combined DBM-IM bone graft, or were left unfilled. Histologic changes were examined 14 days later. The IM bone graft healed through IM ossification with no intermediate cartilage stage. DBM and composite DBM-IM healed through an EC ossification with an intermediate cartilage stage. It is hypothesized that the role of the IM graft is to induce neovascularization into the defect site, and that the undifferentiated mesenchymal cells in the perivascular region of the new blood vessels are induced by the bone morphogenetic protein(s) in the DBM into bone-forming cells.

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“…We have demonstrated that the bone formation and implant fixation results in the DBM/allograft group were comparable to those of the control group consisting of allograft alone. The combination of DBM with allograft has also been reported by other authors (Kohler et al ., ; Ozdemir and Kir, ; Urrutia et al ., ; Ziran et al ., ). Urrutia et al .…”

Section: Discussionmentioning

confidence: 97%

Demineralized bone matrix and human cancellous bone enhance fixation of porous-coated titanium implants in sheep

Babiker

Ding

Overgaard

2013

J Tissue Eng Regen Med

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Allogenic bone graft has been considered the gold standard in connection with bone graft material in revision joint arthroplasty. However, the lack of osteogenic potential and the risk of disease transmission are clinical challenges. The use of osteoinductive materials, such as demineralized bone matrix (DBM), alone or in combination with allograft or commercially available human cancellous bone (CB), may replace allografts, as they have the capability of inducing new bone and improving implant fixation through enhancing bone ongrowth. The purpose of this study was to investigate the effect of DBM alone, DBM with CB, or allograft on the fixation of porous-coated titanium implants. DBM100 and CB produced from human tissue were included. Both materials are commercially available. DBM granules are placed in pure DBM and do not contain any other carrier. Titanium alloy implants, 10 mm long × 10 mm diameter, were inserted bilaterally into the femoral condyles of eight skeletally mature sheep. Thus, four implants with a concentric gap of 2 mm were implanted in each sheep. The gap was filled with: (a) DBM; (b) DBM:CB at a ratio of 1:3; (c) DBM:allograft at a ratio of 1:3; or (d) allograft (gold standard), respectively. A standardized surgical procedure was used. At sacrifice 6 weeks after implantation, both distal femurs were harvested. The implant fixation was evaluated by mechanical push-out testing to test shear mechanical properties between implant and the host bone and by histomorphometry. Non-parametric tests were applied; p < 0.05 was considered significant. Mechanical fixation showed that the strengths among the DBM/CB, DBM/allograft and allograft groups were not statistically different. The strength of the DBM group was 0.01 MPa, which was statistical significantly lower than the other three groups (p < 0.05). Histomorphometry results showed that the bone ongrowth in the DBM group was statistically significantly lower than the other three groups, while the volume fraction of new bone showed no significant difference among all the groups. Our data revealed that adding DBM to CB or to allograft resulted in comparable mechanical properties relative to the gold standard, allograft. We found inferior early effects of DBM alone on the fixation of porous-coated titanium implant in this animal model, while the long-term effects have to be investigated. The combination of DBM with CB, which can be used off the shelf, may represent an alternative to allograft. A cost-benefit analysis is necessary before application in clinical trial.

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Osteogenic enhancement of diaphyseal reconstruction: Comparison of bone grafts in the rabbit

Cited by 8 publications

References 5 publications

Direct Gene Therapy for Bone Regeneration: Gene Delivery, Animal Models, and Outcome Measures

Direct Gene Therapy for Bone Regeneration: Gene Delivery, Animal Models, and Outcome Measures

The Effect of Demineralized Bone Matrix on the Healing of Intramembranous Bone Grafts in Rabbit Skull Defects

Demineralized bone matrix and human cancellous bone enhance fixation of porous-coated titanium implants in sheep

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