Bridging large bone defects with a xenograft composited with autologous bone marrow

Abstract

We have investigated the role of defatted, decalcified xenogenic bone implants composited by impregnation with fresh autologous marrow in bridging large cortical defects. Diaphyseal cortical implants were obtained from orthopaedic operations on humans and from guinea pigs and prepared by treatment with acetone, 0.6 M HCl and ethanol. The composited graft was used to bridge a 3 cm defect in the diaphysis of the ulna of rabbits. Periodic investigations were made clinically, radiographically and histologically and by tetracycline, fluorescence studies up to 20 weeks. Abundant new bone formation was observed in 85.7% of composited human xeno-autografts and in 83.3% of composited guinea pig xeno-autografts. New bone formation was seen in 13.3% of noncomposited xeno-implants. No appreciable antigenicity was observed either clinically or histologically in the grafts. The high degree of success obtained justifies further studies on implants composited by fresh autologous marrow and offers hope for the enhancement of new bone formation clinically, particularly in reconstructive operations for significant skeletal defects. We feel that the osteo-inductive potential of autologous marrow was responsible for the healing of the defects aided by the better internal milieu provided by defatted decalcified xeno implant.

Experimental Comparison of Bovine-Derived Xenograft, Xenograft-Autologous Bone Marrow and Autogenous Bone Graft for the Treatment of Bony Defects in the Rabbit Ulna

“…Xenografts lose their osteogenic and osteoinductive properties during chemical cleaning performed to coun- teract their antigenic properties and prevent transmission of infection [16,17] . Since they cause a hypersensitivity reaction in the host, obstruction develops in the vessels formed between donor tissue and host bed and sequestration in the graft.…”

“…Some experimental and clinical trials performed after this development have shown that impregnation of various types of bone graft with autologous red marrow has had beneficial effects on osteogenesis [10,11,16,[19][20][21][22] .…”

“…The question was whether the addition of bone marrow would compensate for the poor biological capacity of a xenograft. Treatment with a combination of autologous bone marrow and xenograft has been shown to yield a good outcome in bone defects, but some bone pathologies have occurred [10,[14][15][16][17][18] . However, there are insufficient data whether or not xenografts produced with the most recent technology would offer a success similar to autografts when combined with autologous bone marrow.…”

Osteoinductivity of Partially Decalcified Alloimplants in Healing of Large Osteoperiosteal Defects

“…However, this effect has been shown to be dose dependent (Harris et al 1968, Kruger 1975, Norton et al 1968, Yen & Shaw 1972. In the dosage schedule used by us it did not seem to inhibit 'neoosteogenesis' (Gupta & Tuli 1980, Gupta et al 1982. Some osteons showed all the three rings with very narrow central canal, showing that this osteon had formed and virtually matured during 1 month, the period of three dosages.…”

Evaluation of equine cortical bone transplantation in a canine fracture model

“…Mare cortical bone xenografts of low antigenicity have been successfully produced by a cycle of boiling and freezing (Fujinaga and Koike, 1976). Gupta et al (1982) compared defatted and decalcified xenogenic bone implants in large cortical defects repair and reported a high success rate. Zhao et al (1998) reported a successful result using bovine bone graft for the reconstruction of anterior base defects in humans.…”