Repair of segmental long bone defect in rabbit femur using bioactive titanium cylindrical mesh cage

Aims This study reviews the use of a titanium mesh cage (TMC) as an adjunct to intramedullary nail or plate reconstruction of an extra-articular segmental long bone defect. Patients and Methods A total of 17 patients (aged 17 to 61 years) treated for a segmental long bone defect by nail or plate fixation and an adjunctive TMC were included. The bone defects treated were in the tibia (nine), femur (six), radius (one), and humerus (one). The mean length of the segmental bone defect was 8.4 cm (2.2 to 13); the mean length of the titanium mesh cage was 8.3 cm (2.6 to 13). The clinical and radiological records of the patients were analyzed retrospectively. Results The mean time to follow-up was 55 months (12 to 126). Overall, 16 (94%) of the patients achieved radiological filling of their bony defect and united to the native bone ends proximally and distally, resulting in a functioning limb. Complications included device failure in two patients (12%), infection in two (12%), and wound dehiscence in one (6%). Four patients (24%) required secondary surgery, four (24%) had a residual limb-length discrepancy, and one (6%) had a residual angular limb deformity. Conclusion A titanium mesh cage is a useful adjunct in the treatment of an extra-articular segmental defect in a long bone. Cite this article: Bone Joint J 2018;100-B:646–51.

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New Segmental Long Bone Defect Model in Sheep: Quantitative Analysis of Healing with Dual Energy X-Ray Absorptiometry

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-200012000-00042 ◽

2000 ◽

Vol 82 (12) ◽

pp. 61

Author(s):

Frank C. den Boer ◽

Peter Patka ◽

Fred C. Bakker ◽

Burkhard W. Wippermann ◽

Arthur van Lingen ◽

...

Keyword(s):

Quantitative Analysis ◽

Bone Defect ◽

Dual Energy ◽

Long Bone ◽

Defect Model ◽

X Ray ◽

Long Bone Defect

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Bone regeneration response in an experimental long bone defect orthotopically implanted with alginate‐pullulan‐glass‐ceramic composite scaffolds

Journal of Biomedical Materials Research Part B Applied Biomaterials ◽

10.1002/jbm.b.34464 ◽

2019 ◽

Vol 108 (3) ◽

pp. 1129-1140 ◽

Cited By ~ 1

Author(s):

Radu A. Popescu ◽

Flaviu A. Tăbăran ◽

Sidonia Bogdan ◽

Alexandru Fărcăṣanu ◽

Robert Purdoiu ◽

...

Keyword(s):

Bone Regeneration ◽

Bone Defect ◽

Glass Ceramic ◽

Ceramic Composite ◽

Long Bone ◽

Composite Scaffolds ◽

Regeneration Response ◽

Long Bone Defect ◽

Glass Ceramic Composite

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Effects of Calcium Sulfate Combined with Platelet-rich Plasma on Restoration of Long Bone Defect in Rabbits

Chinese Medical Journal ◽

10.4103/0366-6999.176981 ◽

2016 ◽

Vol 129 (5) ◽

pp. 557-561 ◽

Cited By ~ 4

Author(s):

Hua Chen ◽

Xin-Ran Ji ◽

Qun Zhang ◽

Xue-Zhong Tian ◽

Bo-Xun Zhang ◽

...

Keyword(s):

Bone Defect ◽

Calcium Sulfate ◽

Platelet Rich Plasma ◽

Long Bone ◽

Long Bone Defect

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Healing of a Large Long-Bone Defect through Serum-Free In Vitro Priming of Human Periosteum-Derived Cells

Stem Cell Reports ◽

10.1016/j.stemcr.2017.01.005 ◽

2017 ◽

Vol 8 (3) ◽

pp. 758-772 ◽

Cited By ~ 24

Author(s):

Johanna Bolander ◽

Wei Ji ◽

Jeroen Leijten ◽

Liliana Moreira Teixeira ◽

Veerle Bloemen ◽

...

Keyword(s):

Bone Defect ◽

Long Bone ◽

Serum Free ◽

Long Bone Defect

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Critical Long Bone Defect Treated by Magnetic Scaffolds and Fixed by Permanent Magnets

ASME 2013 2nd Global Congress on NanoEngineering for Medicine and Biology ◽

10.1115/nemb2013-93193 ◽

2013 ◽

Author(s):

Alessandro Russo ◽

Silvia Panseri ◽

Tatiana Shelyakova ◽

Monica Sandri ◽

Chiara Dionigi ◽

...

Keyword(s):

Finite Element ◽

Magnetic Nanoparticles ◽

Bone Tissue ◽

Bone Defect ◽

Long Bone ◽

Bone Scaffold ◽

Finite Element Software ◽

Magnetic Forces ◽

Long Bone Defect

Diaphyseal bone defect represents a significant problem for orthopaedic surgeons and patients. In order to improve and fasten bone regenerating process we implanted HA biodegradable magnetized scaffolds in a large animal model critical bone defect. A critical long bone defect was created in 6 sheep metatarsus diaphysis; then we implanted a novel porous ceramic composite scaffold (20.0 mm in length; 6.00 mm inner diameter and 17.00 mm outer diameter), made of Hydroxyapatite that incorporates magnetite (HA/Mgn 90/10), proximally fixated by two small cylindrical permanent parylene coated NdFeB magnets (one 6.00 mm diameter magnetic rod firmly incorporated into the scaffold and one 8.00 mm diameter magnetic rods fitted into proximal medullary canal, both 10.00 mm long); to give stability to the complex bone-scaffold-bone, screws and plate was used as a bridge. Scaffolds biocompatibility was previously assessed in vitro using human osteoblast-like cells. Magnetic forces through scaffold were calculated by finite element software (COMSOL Multiphysics, AC/DC Model). One week after surgery, magnetic nanoparticles functionalized with vascular endothelial growth factor (VEGF) were injected at the mid portion of the scaffold using a cutaneous marker positioned during surgery as reference point. After sixteen weeks, sheep were sacrificed to analyze metatarsi. Macroscopical, radiological and microCT examinations were performed. Macroscopical examination shows bone tissue formation inside scaffold pores and with complete coverage of scaffolds, in particular at magnetized bone-scaffold interface. X-rays show a good integration of the scaffold with a good healing process of critical bone defect, and without scaffolds mobilization. These datas were confirmed by the microCT that shown new formation of bone inside the scaffolds, in particular at magnetized bone-scaffold interface. These preliminary results lead our research to exploiting magnetic forces to stimulate bone formation, as attested in both in vitro and in vivo models and to improve fixation at bone scaffold interface, as calculated by finite element software, and moreover to guide targeted drug delivery without functionalized magnetic nanoparticles dissemination in all body. Histological analysis will be performed to confirm and quantify bone tissue regeneration at both interfaces.

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Repair of Large Segmental Bone Defect using Vascularized Small Corticocancellous Bone in Rabbit Femur

Journal of Reconstructive Microsurgery ◽

10.1055/s-0037-1604437 ◽

2017 ◽

Vol 33 (09) ◽

pp. 649-659

Author(s):

Jong Kang ◽

Dong Suh ◽

Jung Park ◽

Jong Park ◽

Soon Lee ◽

...

Keyword(s):

Bone Defect ◽

Donor Site ◽

The Other ◽

Long Bone ◽

Autogenous Bone ◽

Control Group ◽

Segmental Bone Defect ◽

Segmental Bone ◽

Group B ◽

Rabbit Femur

Background Although free-vascularized long-bone transfer is useful for reconstruction of a large segmental bone defect, it is limited by availability of transplantable bone, meticulous microsurgical technique, and donor-site morbidities. Hence, easier, readily available, and safer surgical procedures are warranted. This study evaluated the effects of vascularized small corticocancellous bone grafting for reconstruction of a large segmental rabbit femur defect. Methods A 1.5 cm defect was created in the femurs of 40 New Zealand white rabbits and divided into a control group (n = 10, bone defect without graft), group A (n = 10, bone defect filled with morselized autogenous bone), group B (n = 10, bone defect grafted with a vascularized small corticocancellous bone and morselized autogenous bone), and group C (n = 10, bone defect grafted with a vascularized small corticocancellous bone). Simple radiographs were taken postoperatively, and bone healing ability was scored using Taira's radiologic scale. Histologic examinations were scored using Emery's histologic scale. The expression of osteogenesis-related growth factors (BMP-2, -4, and -7, VEGF, and RANKL) was analyzed. Results Radiologically, group B showed superior biological efficacy in bone formation and consolidation over the other groups. Histologically, the defect in group B was filled with more abundant mature bone than the other groups. Group B showed higher gene expression of BMP-2, -4, and -7, and VEGF. Conclusions The grafting of the morselized autogenous bone (MSB) combined with the vascularized small corticocancellous bone is more effective than that of the MSB alone for repairing a large segmental bone defect.

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