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

Abstract

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.

Evaluation of horizontal ridge augmentation using beta tricalcium phosphate and demineralized bone matrix: A comparative study

“…Histologic evidence of osteoblasts penetrating the surface of the DBM granules denoted the material’s ability to support osteoblastic cell adhesion ( 21 ). Results showed that the density of the newly formed bone inside surgically created gaps filled with DBM reached 93% of native bone density after 12 weeks ( 22 ). Moreover radiographic evidence of new bone formation after using injectable DBM during sinus elevation surgery was seen following a 6 months healing period ( 23 ).…”

“…With the material’s ability to induce differentiation of mesenchymal cells to form bone as well as serve as a scaffold for osteoprogenitor cells attachment ( 22 , 24 , 25 ), the combined effect of adding both DBM and β-TCP to augment the deficient horizontal alveolar ridge was evaluated in this study.…”

Polycyanoacrylate porous material for bone tissue substitution

“…The third requirement is the open-type porosity structure suitable for vascularization and cell immobilization during the tissuesubstitution process. 18 For proof of concept, we developed material providing for the quick release of wound-healing accelerators-insulin and the relatively slow release of collagen-as the model of morphogenesis proteins. Whereas insulin, which is responsible for wound healing, must be released rapidly in rst several days, the rate of release for collagen, which is responsible for tissue substitution, must be rather slow.…”