The Efficacy of Different Commercially Available Demineralized Bone Matrix Substances in an Athymic Rat Model

Lee, Yu-Po; Jo, Mark; Luna, M. Larralde De; Chien, Bobby; Lieberman, Jay R.; Wang, Jeffrey C.

doi:10.1097/01.bsd.0000175696.66049.f7

Cited by 71 publications

(60 citation statements)

References 19 publications

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“…It is notable that animals in the rhBMP-2, Grafton 1 , and DBX 1 groups performed similarly to other studies utilizing the same doses of these products. 18,21,22,24 Because critics of rhBMP-2 use are concerned about the host inflammatory response demonstrated clinically in the cervical spine and lumbar interbody fusions, 10,11,16,17,34 TrioMatrix 1 was qualitatively and quantitatively evaluated in comparison to rhBMP-2 in a novel MR imaging protocol. Assessment 7 days after surgery demonstrated that the formation of an inflammatory response/fluid collection consistent with that described clinically after the use of rhBMP-2 was avoided with the use of TrioMatrix 1 .…”

Section: Discussionmentioning

confidence: 99%

“…Because previous studies reported highly consistent results for ACS 18,25 in this model, only four animals were included in this negative control group. As in previous similar studies, 18,21,22 for TrioMatrix 1 , Grafton 1 , and DBX 1 , 0.3 cm 3 were implanted on each side for a total volume of 0.6 cm 3 per animal.…”

Section: Study Groupsmentioning

confidence: 99%

“…[13][14][15][16][17] DBMs, which are derived from human cadaveric bone through an acid extraction process, 18 have been associated with a widely variable osteoinductive potency in vivo. [18][19][20][21][22] Ceramic carriers have shown promise in their clinical use as bone graft extenders, 23 but when used alone, provide no exogenous osteoinductivity.…”

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confidence: 99%

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Nanocomposite therapy as a more efficacious and less inflammatory alternative to bone morphogenetic protein‐2 in a rodent arthrodesis model

Hsu¹,

Polavarapu²,

Riaz³

et al. 2011

Journal Orthopaedic Research

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The use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in spine fusion has led to concerns regarding a potential accompanying inflammatory response. This study evaluates a combination therapy (TrioMatrix 1 ; Pioneer Surgical, Inc., Marquette, MI) comprised of a demineralized bone matrix (DBM), hydroxyapatite, and a nanofiber-based collagen scaffold in a rodent spine fusion model. Thirty-six athymic rats that underwent a posterolateral intertransverse spinal fusion were randomly assigned to 1 of 5 treatment groups: absorbable collagen sponge alone (ACS, negative control), 10 mg rhBMP-2 on ACS (positive control), TrioMatrix 1 , Grafton 1 (Osteotech, Inc., Eatontown, NJ), and DBX 1 (Synthes, Inc., West Chester, PA). Both TrioMatrix 1 and rhBMP-2-treated animals demonstrated 100% fusion rates as graded by manual palpation scores 8 weeks after implantation. This rate was significantly greater than those of the ACS, Grafton 1 , and DBX 1 groups. Notably, the use of TrioMatrix 1 as evaluated by microCT quantification led to a greater fusion mass volume when compared to all other groups, including the rhBMP-2 group. T2-weighted axial MRI images of the fusion bed demonstrated a significant host response associated with a large fluid collection with the use of rhBMP-2; this response was significantly reduced with the use of TrioMatrix 1 . Our results therefore demonstrate that a nanocomposite therapy represents a promising, cost-effective bone graft substitute that could be useful in spine fusions where BMP-2 is contraindicated.

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Section: Discussionmentioning

confidence: 99%

Section: Study Groupsmentioning

confidence: 99%

See 1 more Smart Citation

Nanocomposite therapy as a more efficacious and less inflammatory alternative to bone morphogenetic protein‐2 in a rodent arthrodesis model

Hsu¹,

Polavarapu²,

Riaz³

et al. 2011

Journal Orthopaedic Research

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“…This spine fusion model has been previously described. 6,8,13,16 A midline incision was made in the skin, and the transverse processes of L-4 and L-5 were exposed and bilaterally decorticated with a high-speed bur. After this, 0.3 cm 3 of graft material was implanted on each side (total 0.6 cm 3 ).…”

Section: Surgical Procedures For Spinal Fusionmentioning

confidence: 99%

A comparison of commercially available demineralized bone matrices with and without human mesenchymal stem cells in a rodent spinal fusion model

Hayashi

Lord

Suzuki

et al. 2016

SPI

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OBJECTIVE The efficacy of some demineralized bone matrix (DBM) substances has been demonstrated in the spinal fusion of rats; however, no previous comparative study has reported the efficacy of DBM with human mesenchymal stem cells (hMSCs). There is an added cost to the products with stem cells, which should be justified by improved osteogenic potential. The purpose of this study is to prospectively compare the fusion rates of 3 different commercially available DBM substances, both with and without hMSCs. METHODS Posterolateral fusion was performed in 32 mature athymic nude rats. Three groups of 8 rats were implanted with 1 of 3 DBMs: Trinity Evolution (DBM with stem cells), Grafton (DBM without stem cells), or DBX (DBM without stem cells). A fourth group with no implanted material was used as a control group. Radiographs were obtained at 2, 4, and 8 weeks. The rats were euthanized at 8 weeks. Overall fusion was determined by manual palpation and micro-CT. RESULTS The fusion rates at 8 weeks on the radiographs for Trinity Evolution, Grafton, and DBX were 8 of 8 rats, 3 of 8 rats, and 5 of 8 rats, respectively. A significant difference was found between Trinity Evolution and Grafton (p = 0.01). The overall fusion rates as determined by micro-CT and manual palpation for Trinity Evolution, Grafton, and DBX were 4 of 8 rats, 3 of 8 rats, and 3 of 8 rats, respectively. The Trinity Evolution substance had the highest overall fusion rate, however no significant difference was found between groups. CONCLUSIONS The efficacies of these DBM substances are demonstrated; however, the advantage of DBM with hMSCs could not be found in terms of posterolateral fusion. When evaluating spinal fusion using DBM substances, CT analysis is necessary in order to not overestimate fusion.

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“…The osteoinductive ability in DBMs to stimulate bone regeneration is dependent upon the activity of the bone morphogenic proteins (BMPs). Commercially available DBMs have demonstrated the variability of their osteoinductive potential that may reflect differences in their BMP content in rat spinal fusion models [53,71,100].…”

Section: Demineralized Bone Matricesmentioning

confidence: 99%

An update on bone substitutes for spinal fusion

et al. 2009

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With the current advances in spinal surgery, an understanding of the precise biological mechanism of each bone substitute is necessary for inducing successful spinal fusion. In this review, the categories of bone substitutes include allografts, ceramics, demineralized bone matrix, osteoinductive factors, autogenous platelet concentrate, mesenchymal stem cells, and gene therapy. Further, clinical studies have been evaluated by their levels of evidence in order to elucidate the precise effect of the bone substitute employed and to establish clinical guidance. This article will review both clinical studies based on evidence and basic research in current advances in order to avoid as far as possible any chances of failure in the future and to understand cellular biology in novel technologies.

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The Efficacy of Different Commercially Available Demineralized Bone Matrix Substances in an Athymic Rat Model

Abstract: Significant differences exist among commercially available DBMs in forming a spinal fusion in an athymic rat.

Cited by 71 publications

References 19 publications

Nanocomposite therapy as a more efficacious and less inflammatory alternative to bone morphogenetic protein‐2 in a rodent arthrodesis model

Nanocomposite therapy as a more efficacious and less inflammatory alternative to bone morphogenetic protein‐2 in a rodent arthrodesis model

A comparison of commercially available demineralized bone matrices with and without human mesenchymal stem cells in a rodent spinal fusion model

An update on bone substitutes for spinal fusion

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