Limits...
Demineralized Bone Matrix Injection in Consolidation Phase Enhances Bone Regeneration in Distraction Osteogenesis via Endochondral Bone Formation.

Kim JB, Lee DY, Seo SG, Kim EJ, Kim JH, Yoo WJ, Cho TJ, Choi IH - Clin Orthop Surg (2015)

Bottom Line: We examined the effect of percutaneous injection of demineralized bone matrix (DBM) during the consolidation phase on bone regeneration after distraction.DBM administration into the distraction gap at the end of the distraction period resulted in a significantly greater regenerate bone area, trabecular number, and cortical thickness in the rabbit tibial DO model.These data suggest that percutaneous DBM administration at the end of the distraction period or in the early consolidation period may stimulate regenerate bone formation and consolidation in a clinical situation with delayed bone healing during DO.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

Background: Distraction osteogenesis (DO) is a promising tool for bone and tissue regeneration. However, prolonged healing time remains a major problem. Various materials including cells, cytokines, and growth factors have been used in an attempt to enhance bone formation. We examined the effect of percutaneous injection of demineralized bone matrix (DBM) during the consolidation phase on bone regeneration after distraction.

Methods: The immature rabbit tibial DO model (20 mm length-gain) was used. Twenty-eight animals received DBM 100 mg percutaneously at the end of distraction. Another 22 animals were left without further procedure (control). Plain radiographs were taken every week. Postmortem bone dual-energy X-ray absorptiometry and micro-computed tomography (micro-CT) studies were performed at the third and sixth weeks of the consolidation period and histological analysis was performed.

Results: The regenerate bone mineral density was higher in the DBM group when compared with that in the saline injection control group at the third week postdistraction. Quantitative analysis using micro-CT revealed larger trabecular bone volume, higher trabecular number, and less trabecular separation in the DBM group than in the saline injection control group. Cross-sectional area and cortical thickness at the sixth week postdistraction, assessed using micro-CT, were greater in the regenerates of the DBM group compared with the control group. Histological evaluation revealed higher trabecular bone volume and trabecular number in the regenerate of the DBM group. New bone formation was apparently enhanced, via endochondral ossification, at the site and in the vicinity of the injected DBM. DBM was absorbed slowly, but it remained until the sixth postoperative week after injection.

Conclusions: DBM administration into the distraction gap at the end of the distraction period resulted in a significantly greater regenerate bone area, trabecular number, and cortical thickness in the rabbit tibial DO model. These data suggest that percutaneous DBM administration at the end of the distraction period or in the early consolidation period may stimulate regenerate bone formation and consolidation in a clinical situation with delayed bone healing during DO.

No MeSH data available.


Related in: MedlinePlus

The three-dimensional (3D) reconstruction image of one voxel of interest showed that demineralized bone matrix (DBM) group (A) had denser trabecular bones than control group (B) at third week of consolidation period. The 3D reconstruction image of whole regenerate in distraction gap showed that DBM group (C) had well remodeled cortices when compared with control group (D) at the sixth week of consolidation period.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553289&req=5

Figure 3: The three-dimensional (3D) reconstruction image of one voxel of interest showed that demineralized bone matrix (DBM) group (A) had denser trabecular bones than control group (B) at third week of consolidation period. The 3D reconstruction image of whole regenerate in distraction gap showed that DBM group (C) had well remodeled cortices when compared with control group (D) at the sixth week of consolidation period.

Mentions: Sequential images of plain radiography revealed that the DBM group showed more callus formation and faster regeneration than the control group (Fig. 2). At the third week of the consolidation period, callus was more abundant in the DBM group. At the sixth week of the consolidation period, the DBM group showed fusiform-like callus formation with corticalization. At the eighth week of the consolidation period, corticalization was more apparent in the DBM group and insufficiency in bone remodeling was observed in the control group (Fig. 2). Pixel values for the distraction gap area indicated that the DBM group showed higher pixel values than the control group at the early consolidation period (at 2 and 3 weeks, p < 0.05) and pixel values became similar between the two groups after the fourth week of the consolidation period (Fig. 3). In the DBM group, pixel values at the third week of the consolidation period were highest and showed a 49% increase over pixel values at the beginning of the consolidation period. In the control group, pixel values at the sixth week of the consolidation period were highest and showed a 43% increase over pixel values at the beginning of the consolidation period. The DBM group showed 46% higher pixel values than the control group at the second week of the consolidation period, and this was the largest difference. After the second week of the consolidation period, the difference in pixel values between the DBM group and the control group was diminished.


Demineralized Bone Matrix Injection in Consolidation Phase Enhances Bone Regeneration in Distraction Osteogenesis via Endochondral Bone Formation.

Kim JB, Lee DY, Seo SG, Kim EJ, Kim JH, Yoo WJ, Cho TJ, Choi IH - Clin Orthop Surg (2015)

The three-dimensional (3D) reconstruction image of one voxel of interest showed that demineralized bone matrix (DBM) group (A) had denser trabecular bones than control group (B) at third week of consolidation period. The 3D reconstruction image of whole regenerate in distraction gap showed that DBM group (C) had well remodeled cortices when compared with control group (D) at the sixth week of consolidation period.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553289&req=5

Figure 3: The three-dimensional (3D) reconstruction image of one voxel of interest showed that demineralized bone matrix (DBM) group (A) had denser trabecular bones than control group (B) at third week of consolidation period. The 3D reconstruction image of whole regenerate in distraction gap showed that DBM group (C) had well remodeled cortices when compared with control group (D) at the sixth week of consolidation period.
Mentions: Sequential images of plain radiography revealed that the DBM group showed more callus formation and faster regeneration than the control group (Fig. 2). At the third week of the consolidation period, callus was more abundant in the DBM group. At the sixth week of the consolidation period, the DBM group showed fusiform-like callus formation with corticalization. At the eighth week of the consolidation period, corticalization was more apparent in the DBM group and insufficiency in bone remodeling was observed in the control group (Fig. 2). Pixel values for the distraction gap area indicated that the DBM group showed higher pixel values than the control group at the early consolidation period (at 2 and 3 weeks, p < 0.05) and pixel values became similar between the two groups after the fourth week of the consolidation period (Fig. 3). In the DBM group, pixel values at the third week of the consolidation period were highest and showed a 49% increase over pixel values at the beginning of the consolidation period. In the control group, pixel values at the sixth week of the consolidation period were highest and showed a 43% increase over pixel values at the beginning of the consolidation period. The DBM group showed 46% higher pixel values than the control group at the second week of the consolidation period, and this was the largest difference. After the second week of the consolidation period, the difference in pixel values between the DBM group and the control group was diminished.

Bottom Line: We examined the effect of percutaneous injection of demineralized bone matrix (DBM) during the consolidation phase on bone regeneration after distraction.DBM administration into the distraction gap at the end of the distraction period resulted in a significantly greater regenerate bone area, trabecular number, and cortical thickness in the rabbit tibial DO model.These data suggest that percutaneous DBM administration at the end of the distraction period or in the early consolidation period may stimulate regenerate bone formation and consolidation in a clinical situation with delayed bone healing during DO.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

Background: Distraction osteogenesis (DO) is a promising tool for bone and tissue regeneration. However, prolonged healing time remains a major problem. Various materials including cells, cytokines, and growth factors have been used in an attempt to enhance bone formation. We examined the effect of percutaneous injection of demineralized bone matrix (DBM) during the consolidation phase on bone regeneration after distraction.

Methods: The immature rabbit tibial DO model (20 mm length-gain) was used. Twenty-eight animals received DBM 100 mg percutaneously at the end of distraction. Another 22 animals were left without further procedure (control). Plain radiographs were taken every week. Postmortem bone dual-energy X-ray absorptiometry and micro-computed tomography (micro-CT) studies were performed at the third and sixth weeks of the consolidation period and histological analysis was performed.

Results: The regenerate bone mineral density was higher in the DBM group when compared with that in the saline injection control group at the third week postdistraction. Quantitative analysis using micro-CT revealed larger trabecular bone volume, higher trabecular number, and less trabecular separation in the DBM group than in the saline injection control group. Cross-sectional area and cortical thickness at the sixth week postdistraction, assessed using micro-CT, were greater in the regenerates of the DBM group compared with the control group. Histological evaluation revealed higher trabecular bone volume and trabecular number in the regenerate of the DBM group. New bone formation was apparently enhanced, via endochondral ossification, at the site and in the vicinity of the injected DBM. DBM was absorbed slowly, but it remained until the sixth postoperative week after injection.

Conclusions: DBM administration into the distraction gap at the end of the distraction period resulted in a significantly greater regenerate bone area, trabecular number, and cortical thickness in the rabbit tibial DO model. These data suggest that percutaneous DBM administration at the end of the distraction period or in the early consolidation period may stimulate regenerate bone formation and consolidation in a clinical situation with delayed bone healing during DO.

No MeSH data available.


Related in: MedlinePlus