Osteopromotion by a β-Tricalcium Phosphate/Bone Marrow Hybrid Implant for Use in Spine Surgery

Becker, Stephan; Maissen, Otto; Igor, Ponomarev; Stoll, Thierry; Rahn, B. A.; Wilke, Ingo

doi:10.1097/01.brs.0000192762.40274.57

Cited by 52 publications

(31 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, biologically active tissues, like bone marrow aspirate are required when using b-TCP [3]. Bone marrow aspirate has osteopromotive potential due to the presence of osteoprogenitor cells and osteoinductive growth factors, and therefore a combination with calcium phosphates is recommended [4]. The fusion rates for b-TCP have proven to be excellent as graft expander or alone for posterolateral fusion [5,6] and in anterior cervical fusion [7].…”

Section: Introductionmentioning

confidence: 99%

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

et al. 2012

View full text Add to dashboard Cite

Purpose Due to the disadvantages of iliac crest bone and the poor bone quality of autograft gained from decompression surgery, alternative filling materials for posterior lumbar interbody fusion cages have been developed. b-Tricalcium phosphate is widely used in cages. However, data regarding the fusion rate of b-TCP assessed by computer tomography are currently not available. Materials A prospective clinical trial involving 34 patients (56.7 years) was performed: 26 patients were treated with single-level, five patients double-level and three patients triple-level PLIF filled with b-TCP and bone marrow aspirate perfusion, and additional posterior pedicle screw fixation. Fusion was assessed by CT and X-rays 1 year after surgery using a validated fusion scale published previously. Functional status was evaluated with the visual analogue scale and the Oswestry Disability Index before and 1 year after surgery. Results Forty-five levels in 34 patients were evaluated by CT and X-ray with a follow-up period of at least 1 year. Clinically, the average ODI and VAS for leg and back scores improved significantly (P \ 0.001). CT assessment revealed solid fusion in 12 levels (26.67 %) and indeterminate fusion in 15 levels (34.09 %). Inadequate fusion (non-union) was detected in 17 levels (38.63 %). Conclusion The technique of PLIF using b-TCP yielded a good clinical outcome 1 year after surgery, however, a high rate of pseudoarthrosis was found in this series therefore, we do not recommend b-TCP as a bone graft substitute using the PLIF technique.

show abstract

Section: Introductionmentioning

confidence: 99%

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Second, because of the autogenous properties, their application can avoid possible complications, such as immunogenic reactions and disease transmissions, which can come from allogenic or synthetic materials. Various experimental researches have shown considerable evidence of the efficacy of the use of autologous mononuclear cells from bone marrow in combination with various scaffolds in promoting bone formation in the area of bone defects [8,10,11,20,26,37]; however, there have been no studies evaluating these treatments in humans undergoing distraction osteogenesis. We found no difference in the external fixation index, but some benefits in terms of cortical consolidation that permitted earlier weightbearing in patients treated with BMAC plus PRP compared to patients who were not thus treated.…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Aspirate Concentrate and Platelet-rich Plasma Enhanced Bone Healing in Distraction Osteogenesis of the Tibia

Lee¹,

Ryu²,

Kim³

et al. 2014

Clin Orthop Relat Res

View full text Add to dashboard Cite

Background During lower limb lengthening, poor bone regeneration is a devastating complication. Several local or systemic applications have been used to promote osteogenesis, and biologic stimulations are gaining attention, but their utility has not been proven in this setting. Questions/purposes In patients undergoing bilateral tibial lengthening, we compared those receiving an osteotomy site injection of autologous bone marrow aspirate concentrate (BMAC) plus platelet-rich plasma (PRP) with those not receiving such an injection in terms of external fixator index (time in external fixation divided by amount of lengthening), full weightbearing index (time until a patient was permitted to do full weightbearing divided by amount of lengthening), four cortical healing indexes (time until each cortical union divided by amount of lengthening), and callus shape and type. Methods Twenty-two patients (44 tibias) undergoing bilateral tibial lengthening enrolled in this randomized trial. Two patients were excluded, one due to insufficient radiographic evaluation and one who was lost to followup, leaving 20 patients (40 segments) for inclusion. Ten patients (20 segments) received BMAC combined with PRP injection (treatment group) and 10 patients (20 segments) received no injection (control group). All patients underwent stature lengthening for familial short stature with the lengthening over nail technique. Autologous BMAC combined with PRP was injected at the tibial osteotomy site at the end of the index surgery. Mean distraction rates were similar between groups (0.75 mm/day in the treatment group versus 0.72 mm/day in the control group; p = 0.24). Full weightbearing was permitted when we observed radiographic evidence of healing at two cortices; this assessment was made by the surgeon who was blinded to the treatment each patient received. Minimum followup was 24 months (mean, 28 months; range, 24-34 months).

show abstract

“…10,11 Bone marrow has an osteogenic capability in both orthotopic 22 and heterotopic sites, 23 and its combination with adequate scaffolds can enhance bone formation. [6][7][8][9]12,13 In addition, these methods have clinical merits of being autologous, so no concern exists about immunologic responses.…”

Section: Discussionmentioning

confidence: 99%

“…Bone marrow has a good osteogenic ability when combined with porous ceramics, [6][7][8][9] and has the clinical merits of being autologous and intraoperatively available, with harvesting done by a simple, safe aspiration. 10,11 However, porous ceramics have small pores, and a large amount of remaining air can prevent marrow penetration.…”

mentioning

confidence: 99%

Fresh bone marrow introduction into porous scaffolds using a simple low‐pressure loading method for effective osteogenesis in a rabbit model

Yoshii

Sotome

Torigoe

et al. 2008

Journal Orthopaedic Research

View full text Add to dashboard Cite

Recent advances in tissue engineering techniques have allowed porous biomaterials to be combined with osteogenic cells for effective bone regeneration. We developed a simple low-pressure cell-loading method using only syringes and stopcocks, and examined the effect of this method on osteogenesis when applied to the combination of highly porous b-tricalcium phosphate (b-TCP) and fresh autologous bone marrow. Both block and granule b-TCP scaffolds were used to prepare implants in three different ways: without bone marrow as a control, with bone marrow that was allowed to penetrate spontaneously under atmospheric pressure (AP group), and with bone marrow that was seeded under low pressure (ULP group). These implants were transplanted into rabbit intramuscular sites, and the samples were examined biologically and histologically. The penetration efficiency of the block implants after marrow introduction was significantly higher in the ULP group than in the AP group. In the transplanted block samples, alkaline phosphatase activity was significantly higher in the ULP group at 2 weeks after implantation, and significantly more newly formed bone was observed in the ULP group at both 5 and 10 weeks compared with the AP group. Similar results were observed even in the experiment using b-TCP granules, which are smaller than the blocks and frequently used clinically. Because of its convenience and safety, this low-pressure method might be a novel, effective treatment to promote osteogenesis with bone marrow in clinical bone reconstruction surgeries. ß

show abstract

Osteopromotion by a β-Tricalcium Phosphate/Bone Marrow Hybrid Implant for Use in Spine Surgery

Abstract: The combination of beta-TCP and bone marrow has superior osteopromotive properties to venous blood or concentrated mononuclear cells and can be used effectively as a substitute to iliac crest graft.

Cited by 52 publications

References 13 publications

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

The use of beta-tricalcium phosphate and bone marrow aspirate as a bone graft substitute in posterior lumbar interbody fusion

Bone Marrow Aspirate Concentrate and Platelet-rich Plasma Enhanced Bone Healing in Distraction Osteogenesis of the Tibia

Fresh bone marrow introduction into porous scaffolds using a simple low‐pressure loading method for effective osteogenesis in a rabbit model

Contact Info

Product

Resources

About