Restoration of bone defect and enhancement of bone ingrowth using partially demineralized bone matrix and marrow stromal cells

Shih, Hsin-Nung; Shih, Lih‐Yuann; Sung, Tseng-Hwa; Chang, Yi-Jung

doi:10.1016/j.orthres.2005.04.005.1100230609

Cited by 14 publications

(5 citation statements)

References 24 publications

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“…Therefore, these progenitor cells may not have easy access to the ECM. Previous studies showed that the incorporation of MSCs into DBM implants improved the quantity and quality of bone formed in humans and canine models 27–29. Since we sought to examine the osteoinductivity of the in vitro generated ECM alone, the inclusion of osteogenic cells was not considered for this study.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the osteoinductive capacity and angiogenicity of an in vitro generated extracellular matrix

Pham

Kasper

Mistry

et al. 2008

J Biomedical Materials Res

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In this study, the osteoinductive potential of an in vitro generated extracellular matrix (ECM) deposited by marrow stromal cells seeded onto titanium fiber mesh scaffolds and cultured in a flow perfusion bioreactor was investigated. Culture periods of 8, 12, and 16 days were selected to allow for different amounts of ECM deposition by the cells as well as ECM with varying degrees of maturity (Ti/ECM/d8, Ti/ECM/d12, and Ti/ECM/d16, respectively). These ECM-containing constructs were implanted intramuscularly in a rat animal model. After 56 days, histologic analysis of retrieved constructs revealed no bone formation in any of the implants. Surrounding many of the implants was a fibrous capsule, which was often interspersed with fat cells. Within the pore spaces, the predominant tissue response was the presence of blood vessels and young fibroblasts or fat cells. The number of blood vessels on a per area basis calculated from a histomorphometric analysis increased as a function of the amount of ECM within the implanted constructs, with a significant difference between Ti/ECM/d16 and plain Ti constructs. These results indicate that although an in vitro generated ECM alone may not induce bone formation at an ectopic site, its use may enhance the vascularization of implanted constructs.

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Section: Discussionmentioning

confidence: 99%

Analysis of the osteoinductive capacity and angiogenicity of an in vitro generated extracellular matrix

Pham

Kasper

Mistry

et al. 2008

J Biomedical Materials Res

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“…[22][23][24] Notable differences in MSCs have been observed during culture expansion of MSCs including the presence of chromosomal abnormalities, which lead to tumorigenicity concerns. 4,7,25 Also, ex vivo expansion methods are typically utilized to increase the number of bone contributing cells from tissue sources that have sub-efficacious amounts of MSCs (e.g. bone marrow).…”

Section: Discussionmentioning

confidence: 99%

Influence of Adipose-Derived Mesenchymal Stromal Cell Demineralized Bone Composite on New Bone Formation in Critical Sized Cortical Bone Defects

Ehrhart

Chubb

Flaumenhaft

et al. 2015

MRAJ

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The relatively recent discovery that MSCs derived from various tissues will differentiate into osteoblasts in the presence of osteopromotive medium has allowed for new therapeutic opportunities in bone tissue engineering. We recently described the in vitro characteristics of a demineralized bone scaffold containing adipose-derived mesenchymal stromal cells (DBM/hMSC) harvested from human adipose tissue and demonstrated that this combination contains the three components that are considered optimal for bone repair: an osteoconductive scaffold, osteoinductive signaling proteins and osteogenic cells. The objective of this study was to compare and characterize the in vivo bone-forming activity of DBM/hMSC to that of DBM alone, hMSCs alone, cortico-cancellous isograft and human cortico-cancellous xenograft in an athymic rat model. A series of animal experiments were performed comparing new bone formation in critical-sized bone defects implanted with DBM/hMSC, DBM, hMSC, corticocancellous isograft, human cortico-cancellous bone graft or no treatment (empty defect). New bone formation was greatest in bone defects implanted with DBM/hMSC when compared with DBM alone, hMSCs alone, corticocancellous bone isograft, or human corticocancellous bone graft. Together, these data support preclinical proof-of-concept that DBM/hMSC will enhance bone formation in challenging healing environments.

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“…Shih et al . () investigated the effect of DBM on implant fixation in a canine non‐weight‐bearing gap model, and showed a significantly better effect of DBM compared to allograft. However, the DBM used was mixed with mesenchymal stem cells, which are expected to provide osteogenic capacity to DBM.…”

Section: Discussionmentioning

confidence: 99%

“…Its application has focused on spine fusion, fractures and as an extender to other grafting materials in repairing cysts and well‐supported skeletal defects (Lane, ). Regarding implant fixation within revision arthroplasty, only a few clinical trials and animal studies have been published (Cook et al ., ; Shih et al ., ).…”

Section: Introductionmentioning

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.

show abstract

Restoration of bone defect and enhancement of bone ingrowth using partially demineralized bone matrix and marrow stromal cells

Cited by 14 publications

References 24 publications

Analysis of the osteoinductive capacity and angiogenicity of an in vitro generated extracellular matrix

Analysis of the osteoinductive capacity and angiogenicity of an in vitro generated extracellular matrix

Influence of Adipose-Derived Mesenchymal Stromal Cell Demineralized Bone Composite on New Bone Formation in Critical Sized Cortical Bone Defects

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

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