The osteogenic response to distant skeletal injury.

Einhorn, Thomas A.; Simon, Gary; Devlin, Vincent J.; Warman, June; Sidhu, Surita; Vigorita, Vincent J.

doi:10.2106/00004623-199072090-00016

Cited by 93 publications

(57 citation statements)

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“…In our study, a 10-day tibial distraction produced a measurable systemic anabolic effect on bone remodeling when compared to the values measured during the following consolidation phase in the same animals ( Table 1). The results of this experiment confirm previously performed studies examining the systemic influence of local skeletal injury [3,4,8,10,12,16,24,25,32] (Table 2). Our results demonstrate the quick onset of systemic stimulation of bone metabolism.…”

Section: Discussionsupporting

confidence: 89%

“…Causes for the systemic stimulatory effect are believed to be mainly due to the release of local growth factors and to a lesser extent to hormonal changes occurring in the course of bony injury and the subsequent repair [5,10,22]. The injury of the bone marrow is regarded as the trigger of this process [14].…”

Section: Discussionmentioning

confidence: 99%

“…The reasons for this are systemic hormonal changes [3] and locally released growth factors that enter the circulation [10,14,32]. The local and systemic changes after skeletal injury are well-described [24,25].…”

Section: Introductionmentioning

confidence: 99%

“…Involved mediators are bone morphogenetic proteins, insulin-like growth factor, transforming growth factor b (TGF-b), platelet-derived growth factor (PDGF), fibroblast growth factor, prostaglandins, and hormones, such as parathormone, growth hormone, and glucocorticoids [5,35]. The injury of the bone marrow and the resulting release of osteogenic substances primarily lead to this stimulation [10]. It has been shown that osteoblastic cells will be recruited to aid the healing of a distant bone defect [30].…”

Section: Introductionmentioning

confidence: 99%

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Distraction Osteogenesis Enhances Remodeling of Remote Bones of the Skeleton: A Pilot Study

Funk

Krummrey

Perka

et al. 2009

Clin Orthop Relat Res

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Bone injuries have a systemic influence on the remodeling of bone. This effect has not been examined concerning its extent and duration. We measured the systemic effect of distraction osteogenesis on the remodeling of bones of the axial skeleton by means of the mineral apposition rate and bone formation rate in an animal experiment. Distraction osteogenesis was performed on the tibiae of 24 mature Yucatan minipigs. After a 4-day latency period, the tibiae were distracted 2 mm/day for 10 days. The ensuing consolidation phase lasted 10 days. Three fluorescent labeling substances were applied intravenously: calcein green at the second postoperative day, tetracycline 1 day after the end of the distraction phase, and xylene orange 2 days before sacrifice. We prepared ground sections from the ninth right ribs. The mineral apposition rate and bone formation rate were measured histomorphometrically on labeled osteons. The median mineral apposition rate during distraction was 2.39 lm/day (2.12-2.62 lm/ day), which was higher than the rate during consolidation (median, 1.62 lm/day; 1.54-1.84 lm/day).

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Distraction Osteogenesis Enhances Remodeling of Remote Bones of the Skeleton: A Pilot Study

Funk

Krummrey

Perka

et al. 2009

Clin Orthop Relat Res

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“…Our original intention was to use the contralateral limb as the control, but it is clear from these studies that this is not the best control. Remote remodeling and bone density effects have been observed previously in several situations, including marrow ablation, fracture healing and blood loss [3,8,9,20], although the only other reported effect on remote bone regeneration (as opposed to remodeling) is our study with TGF-B2 [25]. It does not seem likely that BMP released from the implant had a direct effect on the contralateral site because for bone ingrowth there was a trend toward the greatest contralateral effect to be associated with the lowest dose.…”

Section: Discussionmentioning

confidence: 79%

Locally delivered rhBMP‐2 enhances bone ingrowth and gap healing in a canine model

Sumner

Turner

Urban

et al. 2004

Journal Orthopaedic Research

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The purpose of the present study was to determine if recombinant human bone morphogenetic protein-2 (rhBMP-2) enhances bone ingrowth into porous-coated implants and gap healing around the implants. In the presence of a 3-mm gap between the implant and host bone, porous-coated implants were placed bilaterally for four weeks in the proximal humeri of skeletally mature, adult male dogs. In three treatment groups, the test implant was treated with HA/TCP and rhBMP-2 in buffer at a dose of 100 pg/ implant ( n = 5), 400 pghmplant (n = 6), or 800 pghmplant ( n = 5) and placed in the left humerus. In these same animals, an internal control implant was treated only with HAlTCP and buffer and placed in the right humerus. These groups were compared with a previously reported external control group of seven animals in which no growth factor was delivered [J. Orthop. Res. 19 (2001) 851.The BMP treated implants in the two lower dose groups had significantly more bone ingrowth than the external controls with the greatest effect in the 100 ghmplant group (a 3.5-fold increase over the external control, p = 0,008). All three dose groups had significantly more bone formation in the 3-mm gap surrounding the BMP treated implants than the external controls with the greatest effect in the 800 pg group (2.9-fold increase, p < 0.001). Thus, application of rhBMP-2 to a porous-coated implant stimulated local bone ingrowth and gap healing. The enhancement of bone formation within the implant (bone ingrowth) was inversely related to dose.

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Approaches to study of ischemia in bone

Winet¹,

Hsieh

Bao

1998

J. Biomed. Mater. Res.

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Ischemic osteonecrosis is a complication of certain traumatic and a number of idiopathic conditions. The course of the disease may result in collapse of the convex member of a joint and osteoarthritis, often requiring arthroplasty. Increasing incidence in young adults poses a challenge for development of long-term joint prostheses. Current status of research into the disease is discussed and three new models using intravital microscopy described. The first, an arterial occlusion (AO) model, creates ischemia by occluding the common iliac artery exclusively, avoiding direct trauma on other tissues in the limb. The second, a total occlusion (TO) model utilizes classical tourniquet occlusion of the thigh vessels. The third, a venous occlusion (VO) model, is also a tourniquet procedure but it blocks occlusion of the femoral artery with a protective sheath. Preliminary results from AO and TO studies are reported which show that reperfusion injury is detectible after ischemia doses as short as 4 h. This complication was confirmed by observation of leukocyte adherence, secondary ischemia, and abnormal vessel leakage. Also, a new quantitation of osteonecrosis is introduced whereby fluorescently-tagged dead osteocytes and computer-based image processing provide values for an "osteonecrosis index." Viewing of all vascular events is made possible by intravital microscopy through a bone chamber window implanted in rabbit tibias. It is proposed that such chronic visual techniques allow quantitation of events leading to osteonecrosis as well as the revascularization, resorption and bone apposition of creeping substitution which characterizes postischemia recovery.

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The osteogenic response to distant skeletal injury.

Cited by 93 publications

References 0 publications

Distraction Osteogenesis Enhances Remodeling of Remote Bones of the Skeleton: A Pilot Study

Distraction Osteogenesis Enhances Remodeling of Remote Bones of the Skeleton: A Pilot Study

Locally delivered rhBMP‐2 enhances bone ingrowth and gap healing in a canine model

Approaches to study of ischemia in bone

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