Treatment of tibial nonunion with bone defect using a heterotopic ossification as autologous bone graft: literature overview and case report

Background: Bone grafts are in high demand due to the increase in the cases of bone defects mainly caused by trauma, old age, and disease-related bone damages. Tissue-engineered calcium phosphate (CaP) biomaterials match the major inorganic contents of bone, thereby could be the potential bone graft substitute. However, CaP-bone grafts lack the osteoinductivity that is vital for effective bone regeneration. In this study, we aimed to test the bone defect healing potential of biomimetically fabricated low dose BMP2-doped CaP (BMP2.BioCaP) grafts in a large animal model.Methods: Low dose BMP2 was doped internally (BMP2-int.BioCaP) or on the surface of CaP (BMP2-sur.BioCaP) grafts during the fabrication process. Our previous study showed the robust bone regenerative potential of BMP2-int.BioCaP and BMP2-sur.BioCaP grafts in the rat ectopic model. In this study, we investigated the bone defect healing potential of BMP2.BioCaP grafts in sheep humerus/femoral defects, as well as compared with that of autologous bone graft and clinically used deproteinized bovine bone (DBB) xenograft.Results: Different ways of BMP2 doping did not affect the surface morphology and degradation properties of the graft materials. Micro-CT and histology results showed robustly higher bone defect-healing potential of the BMP2.BioCaP grafts compared to clinically used DBB grafts. The bone defect healing potential of BMP2.BioCaP grafts was as effective as that of the autologous bone graft. Although, BMP2-int.BioCaP doped half the amount of BMP2 compared to BMP2-sur.BioCaP, its' bone defect healing potential was even robust. The BMP2.BioCaP grafts showed less immunogenicity compared to BioCaP or DBB grafts. The volume density of blood vessel-like and bone marrow-like structures in both BMP2.BioCaP graft groups were in a similar extent to the autologous group. Meticulous observation of higher magnification histological images showed active bone regeneration and remodeling during bone defect healing in BMP2.BioCaP graft groups.Conclusion: The robust bone regenerative potential of BMP2.BioCaP grafts in the ectopic model and in-situ bone defects in small and large animals warrant the pre-clinical studies on large animal critical-sized segmental bone defects.

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Bilateral total knee replacement in severe knee osteoarthritis with large bone defect using autologous bone graft augmentation

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v15i1.1266 ◽

2016 ◽

Vol 15 (1) ◽

Author(s):

Mohd Shahidan Noor Rahin ◽

Khairul Nizam Siron ◽

Ed Simor Khan Mor Japar Khan ◽

Ahmad Hafiz Zulkifly ◽

Nik Fatmy Nik Najmy

Keyword(s):

Bone Graft ◽

Bone Defect ◽

Knee Replacement ◽

Radiological Finding ◽

Varus Deformity ◽

Autologous Bone Graft ◽

Left Knee ◽

Range Of Movement ◽

Bilateral Knee ◽

Autologous Bone

40 years old malay gentleman with underlying gout presenting with severe pain in both knees for 10 years, analgesic dependant and wheelchair ambulation. Examination of right knee shows fixed flexion at 10 degrees, range of movement 10-100 degree flexion, lateral collateral laxity and varus deformity. Left knee had fixed flexion at 10 degrees, range of movement 5-100 degree and varus deformity. Blood investigation showed uric acid. X-ray of bilateral knee showed severe tricompartmental arthritis with large medial tibial defect. The patient has undergone bilateral knee replacement in 5 months interval started with left knee. Surgical technique is the same for both knees, intraoperative shows a large posteromedial bone defect. We used 5mm metal augmentation on the right knee, but due to limited financial resources, we have to use the bone graft from the osteotomized bone for the augmentation on the left side. The bone augmentation was fixed with cancellous screw. The patient was referred to physiotherapy for range of motion exercises. 1 year post operatively patient able to ambulate without aid. Pain score improved. The patient does not require analgesia. Functional and knee score is excellent. Range of movement, bilateral knee are 0-100 degree. Radiological finding shows no evidence of construct failure in both metal block and bone graft construct. Severe arthritis with bone defect is common due to late presentation. Using autologous bone graft can provide good result as using expensive meta block for reconstruction.

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Digital Lengthening with One Stage Autologous Bone Graft for Correction of Flail Toe: A case report

The Foot and Ankle Online Journal ◽

10.3827/faoj.2009.0212.0002 ◽

2009 ◽

Author(s):

Al Kline, DPM ◽

Sarah A. Curran, PhD, BSc(Hons)

Keyword(s):

Case Report ◽

Bone Graft ◽

Autologous Bone Graft ◽

One Stage ◽

Autologous Bone

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Cost effectiveness of tibial nonunion treatment: A comparison between rhBMP-7 and autologous bone graft in two Italian centres

Injury ◽

10.1016/j.injury.2013.08.012 ◽

2013 ◽

Vol 44 (12) ◽

pp. 1871-1879 ◽

Cited By ~ 16

Author(s):

Maria Giorgio Calori ◽

Rodolfo Capanna ◽

Massimiliano Colombo ◽

Pietro De Biase ◽

Carol O'Sullivan ◽

...

Keyword(s):

Cost Effectiveness ◽

Bone Graft ◽

Autologous Bone Graft ◽

Tibial Nonunion ◽

Autologous Bone

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Size Effect of Autologous Bone Graft in Repairing Infected Bone Defect in Rabbits

Journal of Biomaterials and Tissue Engineering ◽

10.1166/jbt.2012.1062 ◽

2012 ◽

Vol 2 (4) ◽

pp. 307-313

Author(s):

Li Gang ◽

Zhi-Yuan Li ◽

Hao Jing ◽

Yue Zhou ◽

Ning-Min Hu ◽

...

Keyword(s):

Size Effect ◽

Bone Graft ◽

Bone Defect ◽

Autologous Bone Graft ◽

Autologous Bone

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Distal tibial aneurysmal bone cyst treatment by using a proximal fibular autologous bone graft: a case report

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2004.03.001 ◽

2004 ◽

Vol 43 (3) ◽

pp. 179-184 ◽

Cited By ~ 2

Author(s):

Harmesh Kapoor ◽

Devender Singh ◽

Naval Bhatia ◽

Deepak Chaudhary ◽

Awadesh Kumar Singh

Keyword(s):

Case Report ◽

Bone Graft ◽

Aneurysmal Bone Cyst ◽

Bone Cyst ◽

Autologous Bone Graft ◽

Autologous Bone

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Bioreactor as a New Resource of Autologous Bone Graft to Overcome Bone Defect In Vivo

Clinical Reviews in Bone and Mineral Metabolism ◽

10.1007/s12018-017-9237-5 ◽

2017 ◽

Vol 15 (4) ◽

pp. 139-150

Author(s):

Ahmad Jabir Rahyussalim ◽

Aldo Fransiskus Marsetio ◽

Tri Kurniawati

Keyword(s):

Bone Graft ◽

Bone Defect ◽

Autologous Bone Graft ◽

Autologous Bone

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Platelet-rich fibrin did not affect autologous bone graft in repairing alveolar clefts

Journal of Oral and Maxillofacial Surgery Medicine and Pathology ◽

10.1016/j.ajoms.2021.01.011 ◽

2021 ◽

Author(s):

Arintara Thanasut ◽

Onanong Silkosessak ◽

Keskanya Subbalekha

Keyword(s):

Bone Graft ◽

Autologous Bone Graft ◽

Platelet Rich Fibrin ◽

Autologous Bone

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Combining Microfractures, Autologous Bone Graft, and Autologous Matrix-Induced Chondrogenesis for the Treatment of Juvenile Osteochondral Talar Lesions

Foot & Ankle International ◽

10.1177/1071100716687367 ◽

2017 ◽

Vol 38 (5) ◽

pp. 485-495 ◽

Cited By ~ 17

Author(s):

Riccardo D’Ambrosi ◽

Camilla Maccario ◽

Chiara Ursino ◽

Nicola Serra ◽

Federico Giuseppe Usuelli

Keyword(s):

Bone Graft ◽

Repeated Measures ◽

Osteochondral Lesion ◽

Young Patients ◽

Case Series ◽

Autologous Bone Graft ◽

Lesion Size ◽

Level Of Evidence ◽

Significant Difference ◽

Autologous Bone

Background: The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT). Methods: Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean lesion size measured during surgery was 1.1 cm3 ± 0.5 cm3. We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3. Lesion area significantly reduced from 119.1 ± 29.1 mm2 preoperatively to 77.9 ± 15.8 mm2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm2 to 85.3 ± 14.5 mm2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011). Conclusions: The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life. Level of Evidence: Level IV, retrospective case series.

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