The healing of segmental bone defects induced by demineralized bone matrix. A radiographic and biomechanical study.

Einhorn, Thomas A.; Lane, Joseph M.; Burstein, Albert H.; Kopman, C R; Vigorita, Vincent J.

doi:10.2106/00004623-198466020-00015

Cited by 261 publications

(118 citation statements)

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“…An established, critically sized, femoral defect rat model was used in this study [37]. All procedures were approved by the operative institution's Animal Care and Use Committee.…”

Section: Operative Proceduresmentioning

confidence: 99%

Silk based biomaterials to heal critical sized femur defects

Meinel

Betz

Fajardo

et al. 2006

Bone

221

179

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“…An established, critically sized, femoral defect rat model was used in this study [37]. All procedures were approved by the operative institution's Animal Care and Use Committee.…”

Section: Operative Proceduresmentioning

confidence: 99%

Silk based biomaterials to heal critical sized femur defects

Meinel

Betz

Fajardo

et al. 2006

Bone

221

179

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“…Torque to failure and stiffness both were lower in the infection group than in the control group at 6 weeks, but with the numbers available for testing, they were not different at 3 weeks (p = 0.615 and p = 1, respectively; Table 2 [3][4][5][6][7][8][9][10][11][12][13][14][15][16]; p = 0.004) both were greater in the control group than in the group with infection. Maximum torque to failure was lower in the infection group than in the control group at all time points.…”

Section: Resultsmentioning

confidence: 99%

“…Rat osteosynthesis models have previously used open incisions and stabilization with plates or external fixator systems [4,8,9,17]. Although these systems are commonly associated with gap osteotomy models, a fracture model could be similarly achieved by making a single saw cut (rather than two needed for a gap osteotomy).…”

Section: Discussionmentioning

confidence: 99%

“…Results Infection decreased callus strength at 6 weeks. Torque to failure (299.07 ± 65.53 Nmm versus 107.20 ± 88.81, mean difference with 95% confidence interval, 192 ; p = 0.007) and stiffness at 6 weeks (11.28 ± 2.67 Nmm versus 2.03 ± 1.68, mean difference with 95% confidence interval, 9 [3][4][5][6][7][8][9][10][11][12][13][14][15][16]; p = 0.004) both were greater in the control group than in the group with infection.…”

mentioning

confidence: 98%

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Can Normal Fracture Healing Be Achieved When the Implant Is Retained on the Basis of Infection? An Experimental Animal Model

Bilgili

Balcı

Karaytuğ

et al. 2015

Clin Orthop Relat Res

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Background Infection after open fractures is a common complication. Treatment options for infections developed after intramedullary nailing surgery remain a topic of controversy. We therefore used a rat fracture model to evaluate the effects of infection on osseous union when the implant was maintained.Questions/purposes In a rat model, (1) does infection alter callus strength; (2) does infection alter the radiographic appearance of callus; and (3) does infection alter the histological properties of callus? Methods An open femoral fracture was created and fixed with an intramedullary Kirschner wire in 72 adult male Sprague-Dawley rats, which were divided into two study groups. In the infection group, the fracture site was contaminated with Staphylococcus aureus (36 animals), whereas in the control group, there was no bacterial contamination (36 animals). No antibiotics were used either for prophylaxis or for treatment. We performed biomechanical (maximum torque causing failure and stiffness), radiographic (Lane and Sandhu scoring for callus formation), and histologic (scoring for callus maturity) assessments at 3 and 6 weeks. The number of bacteria colonies on the femur, wire, and soft tissue inside knee were compared to validate that we successfully created an infection model. The number of bacteria colonies in the soft tissue inside the knee was higher in the infection group after 6 weeks than after the third week, demonstrating the presence of locally aggressive infection. Results Infection decreased callus strength at 6 weeks. Torque to failure (299.07 ± 65.53 Nmm versus 107.20 ± 88.81, mean difference with 95% confidence interval, 192 [43-340]; p = 0.007) and stiffness at 6 weeks (11.28 ± 2.67 Nmm versus 2.03 ± 1.68, mean difference with 95% confidence interval, 9 [3-16]; p = 0.004) both were greater in the control group than in the group with infection.

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“…A bone graft substitute with potential benefit for addressing bone defects around cementless implants is demineralized bone matrix (DBM) [9,20,21]. DBM, produced by acid extraction of the mineralized phase of bone to create a composite of noncollagenous proteins, growth factors, and collagen [12], is capable of inducing osteogenesis by recruiting host mesenchymal stem cells [37].…”

Section: Introductionmentioning

confidence: 99%

The Otto Aufranc Award: Demineralized Bone Matrix Around Porous Implants Promotes Rapid Gap Healing and Bone Ingrowth

Lim

Bobyn

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Noncemented revision arthroplasty is often complicated by the presence of bone implant gaps that reduce initial stability and biologic fixation. Demineralized bone matrix has osteoinductive properties and therefore the potential to enhance gap healing and porous implant fixation. Questions/purposes We determined at what times and to what extent demineralized bone matrix promotes gap healing and bone ingrowth around a porous implant. Methods We inserted porous titanium implants into the proximal metaphyses of canine femora and humeri, with an initial 3-mm gap between host cancellous bone and implants. We left the gaps empty (control; n = 12) or filled them with either demineralized bone matrix (n = 6) or devitalized demineralized bone matrix (negative control; n = 6) and left them in situ for 4 or 12 weeks. We quantified volume healing of the gap with new bone using threedimensional micro-CT scanning and quantified apposition and ingrowth using backscattered scanning electron microscopy. Results The density of bone inside gaps filled with demineralized bone matrix reached 64% and 93% of surrounding bone density by 4 and 12 weeks, respectively. Compared with empty controls and negative controls at 4 and 12 weeks, gap healing using demineralized bone matrix was two to three times greater and bone ingrowth and apposition were up to 15 times greater. Conclusions Demineralized bone matrix promotes rapid bone ingrowth and gap healing around porous implants. Clinical Relevance Demineralized bone matrix has potential for enhancing implant fixation in revision arthroplasty.

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The healing of segmental bone defects induced by demineralized bone matrix. A radiographic and biomechanical study.

Cited by 261 publications

References 0 publications

Silk based biomaterials to heal critical sized femur defects

Silk based biomaterials to heal critical sized femur defects

Can Normal Fracture Healing Be Achieved When the Implant Is Retained on the Basis of Infection? An Experimental Animal Model

The Otto Aufranc Award: Demineralized Bone Matrix Around Porous Implants Promotes Rapid Gap Healing and Bone Ingrowth

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