Locking compression plate fixation of critical-sized bone defects in sheep. Development of a model for veterinary bone tissue engineering

Marcondes, Geissiane de Moraes; Paretsis, Nicole Fidalgo; Souza, Anderson Fernando de; Ruivo, Maria Raquel Bellomo Agrello; Rego, Mario Antonio Ferraro; Nóbrega, Fernanda Silveira; Cortopassi, Silvia Renata Gaído; Zoppa, André Luis do Valle de

doi:10.1590/acb360601

Cited by 7 publications

(8 citation statements)

References 27 publications

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“…The current study retrospectively assessed certain surgeon-selected factors such as plate length and plate positioning during locking plate stabilization of a 2 cm caprine tibial segmental defect in vivo. To our knowledge, this is the first publication to explore these factors in small ruminants (sheep and goats) and few publications regarding long-term outcome of long-bone locking plate fixation exist in the veterinary literature [ 18 ]. In human medicine, locking compression plate fixation is commonly applied to supracondylar femoral fractures, and retrospective analysis of patient and surgeon-related factors related to fixation failure has associated shorter plate lengths with increased incidence of implant failure and fracture [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, these locking compression plate characteristics and the effect of plate position have not been assessed in vivo in a caprine segmental defect model. In addition, few studies report complications following use of locking plate fracture fixation in animals and few focus on translational research species such as sheep and goats [ 18 ]. Therefore, the goal of this research was to assess a large cohort of goats enrolled in an unrelated orthopedic study in which a tibial segmental defect was stabilized with bridging locking plates and to analyze plate-bone positioning factors associated with implant failure in the form of postoperative fracture complication.…”

Section: Introductionmentioning

confidence: 99%

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In vitro analysis and in vivo assessment of fracture complications associated with use of locking plate constructs for stabilization of caprine tibial segmental defects

et al. 2023

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Purpose Locking plate fixation of caprine tibial segmental defects is widely utilized for translational modeling of human osteopathology, and it is a useful research model in tissue engineering and orthopedic biomaterials research due to its inherent stability while maintaining unobstructed visualization of the gap defect and associated healing. However, research regarding surgical technique and long-term complications associated with this fixation method are lacking. The goal of this study was to assess the effects of surgeon-selected factors including locking plate length, plate positioning, and relative extent of tibial coverage on fixation failure, in the form of postoperative fracture. Methods In vitro, the effect of plate length was evaluated using single cycle compressive load to failure mechanical testing of locking plate fixations of caprine tibial gap defects. In vivo, effects of plate length, positioning, and relative tibial coverage were evaluated using data from a population of goats enrolled in ongoing orthopedic research which utilized locking plate fixation of 2 cm tibial diaphyseal segmental defects to evaluate bone healing over 3, 6, 9, and 12 months. Results In vitro, no significant differences in maximum compressive load or total strain were noted between fixations using 14 cm locking plates and 18 cm locking plates. In vivo, both plate length and tibial coverage ratio were significantly associated with postoperative fixation failure. The incidence of any cortical fracture in goats stabilized with a 14 cm plate was 57%, as compared with 3% in goats stabilized with an 18 cm plate. Craniocaudal and mediolateral angular positioning variables were not significantly associated with fixation failure. Decreasing distance between the gap defect and the proximal screw of the distal bone segment was associated with increased incidence of fracture, suggesting an effect on proximodistal positioning on overall fixation stability. Conclusions This study emphasizes the differences between in vitro modeling and in vivo application of surgical fixation methods, and, based on the in vivo results, maximization of plate-to-tibia coverage is recommended when using locking plate fixation of the goat tibial segmental defect as a model in orthopedic research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

In vitro analysis and in vivo assessment of fracture complications associated with use of locking plate constructs for stabilization of caprine tibial segmental defects

et al. 2023

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“…There are implant-specific differences between ILNs and LCPs in their composition and the location where they can be applied to the tibia, which can influence their mechanical behavior ( 3 , 9 ). ILNs are placed within the medullary cavity, whereas LCPs are placed on the cortical/periosteal surface.…”

Section: Discussionmentioning

confidence: 99%

“…Threaded drill sleeves were used to align the pilot holes for the remaining screws. Locking screws (5-mm) were placed in all holes except those at the level of the ostectomy (4 screws each in the proximal and distal segments) ( 9 ). Three additional 5.0-mm locking screws were placed into the open holes of the LCP (holes 5 through 7) to ensure there would not be a focal area of stress placed on the plate during biomechanical testing.…”

Section: Methodsmentioning

confidence: 99%

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Biomechanical evaluation of interlocking nail and locking compression plating for stabilization of ovine critical-sized segmental tibia defects

Koch¹,

Johnson²,

Smith³

et al. 2023

Ann Transl Med

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Background: Segmental large volume bone loss resulting from fracture or osseous neoplasia is a major challenge to orthopedic surgeons and there is an ongoing quest to identify treatments that optimize healing.To advance treatment, large animal translational models-such as the ovine critical-sized tibia defect modelare instrumental for testing of novel scaffolds for bone regeneration. However, little standardization in the implants utilized for defect stabilization has been determined and current commercially available implants may be inadequate to replicate the strength of the native tibia. We hypothesize that a 10-mm interlocking nail (ILN) would be stiffer in axial, bending, and torsional loading than its 8-mm counterpart and would be stiffer in axial and torsional loading compared to a 4.5-mm broad locking compression plate (LCP).Methods: Tibias were harvested from 24 ovine hind limbs from skeletally mature ewes euthanized for reasons unrelated to this study and were randomized to treatment group. An ex vivo comparison of a novel 10-mm angle-stable non-tapered ILN was compared to a commercially available 8-mm angle-stable tapered ILN and a broad LCP in an ovine critical-sized (5-cm) tibia defect model. Axial stiffness, torsional stiffness, and bending stiffness were determined in control intact tibia and tibial constructs in the three treatment groups. Following implantation, radiography was performed in all limbs and tibia length and cortical and medullary cavity diameter were measured. Comparisons between groups were assessed with a one-way analysis of variance. Significance was set at P<0.05. Results:The 10-mm ILN in tibia containing a 5-cm ostectomy gap most closely replicated the structural properties of intact tibia compared with other constructs. The 10-mm ILN had significantly stronger torsional (P<0.001) and bending (P=0.002) stiffness than the 8-mm ILN, and was significantly stronger than the LCP in axial (P=0.04) and torsional (P=0.01) stiffness.Conclusions: A 10-mm ILN used to stabilize an ovine critically-sized tibia defect most closely mimicked the structural properties of the intact tibia when compared to a 8-mm ILN or broad LCP. Further in vivo testing will aid in determining which stabilization method is best suited for testing of novel tissue engineering and bone healing studies.

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Bone Tissue Engineering With Chitosan, Carbon Nanotubes, and Hydroxyapatite Biomaterials Enriched With Mesenchymal Stem Cells: A Radiographic and Histological Evaluation in a Sheep Model Undergoing Ostectomy (Bone Tissue Engineering in a Sheep Model)

de Moraes Marcondes,

Paretsis,

da Silva

et al. 2024

J Biomed Mater Res

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Comminuted fractures associated with tissue loss can adversely affect bone regeneration. Biomaterials enriched with mesenchymal stem cells (MSCs) employed for supporting osteosynthesis and potentiating osteoconduction are necessary to fill these bone defects. Natural compound biomaterials, similar to bone tissue, have been extensively tested in animal models for clinical use. Bone tissue engineering studies have used critical‐size defects in ovine tibia monitored by imaging and histological examinations to evaluate the regenerative process. This study aimed to monitor the regenerative process in ovine tibial defects with or without chitosan, carbon nanotubes, or hydroxyapatite biomaterials, enriched or not enriched with MSCs. A 3‐cm ostectomy was performed in 18 female Suffolk sheep. A 10‐hole 4.5 mm narrow locking compression plate was used for osteosynthesis. The animals were randomly divided into three groups (n = 6): control (CON); defects filled with chitosan, carbon nanotubes, and hydroxyapatite biomaterial (BIO); and the same biomaterial enriched with bone marrow MSCs (BIO + CELL). The animals were evaluated monthly using radiographic examinations until 90 postoperative days, when they were euthanized. The limbs were subjected to micro‐computed tomography (micro‐CT), and bone specimens were subjected to histological evaluations. The radiographic examinations revealed construction stability without plate deviation, fracture, or bone lysis. Micro‐CT evaluation demonstrated a difference in bone microarchitecture between the CON and biomaterial treatment groups (BIO and BIO + CELL). In the histological evaluations, the CON group did not demonstrate bone formation, and in the treatment groups (BIO and BIO + CELL), biocompatibility with sheep tissue was noted, and bone formation with trabeculae interspersed with remnants of the biomaterial was observed, with no differences between the groups. In conclusion, biomaterials present osteoconduction with beneficial characteristics for filling bone‐lost fractures, and MSCs did not interfere with bone formation.

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Locking compression plate fixation of critical-sized bone defects in sheep. Development of a model for veterinary bone tissue engineering

Cited by 7 publications

References 27 publications

In vitro analysis and in vivo assessment of fracture complications associated with use of locking plate constructs for stabilization of caprine tibial segmental defects

In vitro analysis and in vivo assessment of fracture complications associated with use of locking plate constructs for stabilization of caprine tibial segmental defects

Biomechanical evaluation of interlocking nail and locking compression plating for stabilization of ovine critical-sized segmental tibia defects

Bone Tissue Engineering With Chitosan, Carbon Nanotubes, and Hydroxyapatite Biomaterials Enriched With Mesenchymal Stem Cells: A Radiographic and Histological Evaluation in a Sheep Model Undergoing Ostectomy (Bone Tissue Engineering in a Sheep Model)

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