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Repair of segmental load-bearing bone defect by autologous mesenchymal stem cells and plasma-derived fibrin impregnated ceramic block results in early recovery of limb function.

Ng MH, Duski S, Tan KK, Yusof MR, Low KC, Rose IM, Mohamed Z, Bin Saim A, Idrus RB - Biomed Res Int (2014)

Bottom Line: Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0).Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%).Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa).

View Article: PubMed Central - PubMed

Affiliation: Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia.

ABSTRACT
Calcium phosphate-based bone substitutes have not been used to repair load-bearing bone defects due to their weak mechanical property. In this study, we reevaluated the functional outcomes of combining ceramic block with osteogenic-induced mesenchymal stem cells and platelet-rich plasma (TEB) to repair critical-sized segmental tibial defect. Comparisons were made with fresh marrow-impregnated ceramic block (MIC) and partially demineralized allogeneic bone block (ALLO). Six New Zealand White female rabbits were used in each study group and three rabbits with no implants were used as negative controls. By Day 90, 4/6 rabbits in TEB group and 2/6 in ALLO and MIC groups resumed normal gait pattern. Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0). Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%). Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa). In conclusion, TEB can repair critical-sized segmental load-bearing bone defects and restore limb function.

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Gross appearance of postimplanted experimental tibia compared with contralateral controls. All groups maintained equal length between test and contralateral tibiae. TEB showed good continuity of cortices along the bone-implant-bone interphases. Implant material for ALLO and MIC groups are still visible. Lt: implanted left tibia; Rt: normal right tibia.
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fig4: Gross appearance of postimplanted experimental tibia compared with contralateral controls. All groups maintained equal length between test and contralateral tibiae. TEB showed good continuity of cortices along the bone-implant-bone interphases. Implant material for ALLO and MIC groups are still visible. Lt: implanted left tibia; Rt: normal right tibia.

Mentions: Regardless of partial or complete union, bone lengths of the treated limbs were maintained in all treatment groups. Three rabbits in TEB achieved complete union showing good continuity of cortices along the bone-implant-bone interphases while the other three showed partial union. In this group, graft could no longer be distinguished from the surrounding bone (Figure 4). In ALLO group, partial union was seen in four rabbits and nonunion in two. In these nonunion rabbits, residual allografts were still visible and soft tissues were found enveloping the allografts. In MIC group, partial union was seen in three of the rabbits and nonunion in other three. In these nonunion rabbits, substantial amount of residual ceramic surrounded by soft tissues were noted. No bone union was achieved in the negative control group.


Repair of segmental load-bearing bone defect by autologous mesenchymal stem cells and plasma-derived fibrin impregnated ceramic block results in early recovery of limb function.

Ng MH, Duski S, Tan KK, Yusof MR, Low KC, Rose IM, Mohamed Z, Bin Saim A, Idrus RB - Biomed Res Int (2014)

Gross appearance of postimplanted experimental tibia compared with contralateral controls. All groups maintained equal length between test and contralateral tibiae. TEB showed good continuity of cortices along the bone-implant-bone interphases. Implant material for ALLO and MIC groups are still visible. Lt: implanted left tibia; Rt: normal right tibia.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109366&req=5

fig4: Gross appearance of postimplanted experimental tibia compared with contralateral controls. All groups maintained equal length between test and contralateral tibiae. TEB showed good continuity of cortices along the bone-implant-bone interphases. Implant material for ALLO and MIC groups are still visible. Lt: implanted left tibia; Rt: normal right tibia.
Mentions: Regardless of partial or complete union, bone lengths of the treated limbs were maintained in all treatment groups. Three rabbits in TEB achieved complete union showing good continuity of cortices along the bone-implant-bone interphases while the other three showed partial union. In this group, graft could no longer be distinguished from the surrounding bone (Figure 4). In ALLO group, partial union was seen in four rabbits and nonunion in two. In these nonunion rabbits, residual allografts were still visible and soft tissues were found enveloping the allografts. In MIC group, partial union was seen in three of the rabbits and nonunion in other three. In these nonunion rabbits, substantial amount of residual ceramic surrounded by soft tissues were noted. No bone union was achieved in the negative control group.

Bottom Line: Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0).Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%).Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa).

View Article: PubMed Central - PubMed

Affiliation: Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia.

ABSTRACT
Calcium phosphate-based bone substitutes have not been used to repair load-bearing bone defects due to their weak mechanical property. In this study, we reevaluated the functional outcomes of combining ceramic block with osteogenic-induced mesenchymal stem cells and platelet-rich plasma (TEB) to repair critical-sized segmental tibial defect. Comparisons were made with fresh marrow-impregnated ceramic block (MIC) and partially demineralized allogeneic bone block (ALLO). Six New Zealand White female rabbits were used in each study group and three rabbits with no implants were used as negative controls. By Day 90, 4/6 rabbits in TEB group and 2/6 in ALLO and MIC groups resumed normal gait pattern. Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0). Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%). Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa). In conclusion, TEB can repair critical-sized segmental load-bearing bone defects and restore limb function.

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