A Decellularized Porcine Xenograft-Derived Bone Scaffold for Clinical Use as a Bone Graft Substitute: A Critical Evaluation of Processing and Structure

Background: Bone grafts are used in approximately one half of all musculoskeletal surgeries. Autograft bone is the historic gold standard but is limited in supply and its harvest imparts significant morbidity to the patient. Alternative sources of bone graft include allografts, synthetics and, less commonly, xenografts which are taken from animal species. Xenografts are available in unlimited supply from healthy animal donors with controlled biology, avoiding the risk of human disease transmission, and may satisfy current demand for bone graft products. Methods: In the current study, cancellous bone was harvested from porcine femurs and subjected to a novel decellularization protocol to derive a bone scaffold. Results: The scaffold was devoid of donor cellular material on histology and DNA sampling (p < 0.01). Microarchitectural properties important for osteoconductive potential were preserved after decellularization as shown by high resolution imaging modalities. Proteomics data demonstrated similar profiles when comparing the porcine bone scaffold against commercially available human demineralized bone matrix approved for clinical use. Conclusion: We are unaware of any porcine-derived bone graft products currently used in orthopaedic surgery practice. Results from the current study suggest that porcine-derived bone scaffolds warrant further consideration to serve as a potential bone graft substitute.

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In Vivo Evaluation of Demineralized Bone Matrix as a Bone Graft Substitute for Posterior Spinal Fusion

Spine ◽

10.1097/00007632-199504150-00002 ◽

1995 ◽

Vol 20 (8) ◽

pp. 877-886 ◽

Cited By ~ 46

Author(s):

Stephen D. Cook ◽

Jeanette E. Dalton ◽

Ann B. Prewett ◽

Thomas S. Whitecloud

Keyword(s):

Bone Graft ◽

Spinal Fusion ◽

Demineralized Bone Matrix ◽

Bone Matrix ◽

Posterior Spinal Fusion ◽

Bone Graft Substitute ◽

In Vivo Evaluation ◽

Demineralized Bone

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Does xenogeneic demineralized bone matrix have clinical utility as a bone graft substitute?

Medical Hypotheses ◽

10.1016/0306-9877(95)90195-7 ◽

1995 ◽

Vol 45 (1) ◽

pp. 27-32 ◽

Cited By ~ 28

Author(s):

J.E. Block ◽

J. Poser

Keyword(s):

Bone Graft ◽

Clinical Utility ◽

Demineralized Bone Matrix ◽

Bone Matrix ◽

Bone Graft Substitute ◽

Demineralized Bone

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A porcine xenograft‐derived bone scaffold is a biocompatible bone graft substitute: An assessment of cytocompatibility and the alpha‐Gal epitope

Xenotransplantation ◽

10.1111/xen.12534 ◽

2019 ◽

Vol 26 (5) ◽

Cited By ~ 6

Author(s):

Daniel N. Bracey ◽

Thorsten M. Seyler ◽

Alexander H. Jinnah ◽

Thomas L. Smith ◽

David A. Ornelles ◽

...

Keyword(s):

Bone Graft ◽

Bone Graft Substitute ◽

Bone Scaffold ◽

Porcine Xenograft

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Evaluation of Demineralized Bone Matrix Particles Delivered by Alginate Hydrogel for a Bone Graft Substitute: An Animal Experimental Study

Medical Science Monitor ◽

10.12659/msm.928617 ◽

2021 ◽

Vol 27 ◽

Author(s):

Zhiqiang Yang ◽

Lingfei Xiao ◽

Zhouming Deng ◽

Lin Cai ◽

Yuanlong Xie

Keyword(s):

Experimental Study ◽

Bone Graft ◽

Demineralized Bone Matrix ◽

Bone Matrix ◽

Bone Graft Substitute ◽

Alginate Hydrogel ◽

Animal Experimental Study ◽

Demineralized Bone

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Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211025197 ◽

2021 ◽

pp. 105566562110251

Author(s):

Vijay Kumar ◽

Vidya Rattan ◽

Sachin Rai ◽

Satinder Pal Singh ◽

Jai Kumar Mahajan

Keyword(s):

Bone Graft ◽

Iliac Crest ◽

Demineralized Bone Matrix ◽

Bone Matrix ◽

Volumetric Analysis ◽

Group I ◽

Alveolar Bone Grafting ◽

Group Ii ◽

Demineralized Bone

Objective: Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes. Design: Prospective, randomized, parallel groups, double-blind, controlled trial. Setting: Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh. Participants: Twenty patients with UCLP. Interventions: Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months. Outcomes Measures: Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of hospital stay, cost of surgery, alar base symmetry, and donor site morbidity associated with iliac crest harvesting. Results: Volumetric analysis through Cavalieri principle revealed comparable bone uptake at follow-up of 6 months between group I (70%) and group II (69%). Modified assessment tool showed no significant difference between horizontal and vertical bone scores over short- and long-term follow-up. In group II, there was higher cost of surgery, but no donor site morbidity unlike group I. Conclusions: Demineralized bone matrix proved analogous to iliac crest bone graft as per volumetric analysis over shorter period. However, although statistically insignificant, net bone volume achieved was lower than the iliac crest graft at longer follow-up.

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