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DeKeyser GJ, Thorne T, Olsen A, Haller JM. Validation of a novel large animal intra-articular tibial plafond fracture model. Clin Biomech (Bristol, Avon) 2023; 101:105854. [PMID: 36542910 DOI: 10.1016/j.clinbiomech.2022.105854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/20/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Large animal fracture models that allow for anatomic fracture fixation are currently lacking. It was hypothesized that a compressed air impaction system can generate a reproducible tibial plafond fracture and be adjustable to create fractures consistent with high and low energy fractures seen in humans. METHODS Pilot testing of the impaction system was done by impacting polyurethane foam blocks at varying compressed air pressures. A guillotine impaction test was performed on the same foam blocks to create an energy conversion. A total of 12 porcine hindlimb hindlimbs were subjected to low-energy (42.2 J) and high-energy (73.9 J) impact to create tibial plafond fractures. FINDINGS Guillotine impaction test demonstrated strong correlations between potential energy and foam block impaction depth (R2 = 0.99). Compressed air impaction system test strongly correlated with foam block impaction depth (R2 = 0.99). All six porcine hindlimbs in the low-energy group developed simple coronal split tibial plafond fractures. All six porcine hindlimbs in the high-energy group developed complex, multi-fragmentary tibial plafond fractures. INTERPRETATION This porcine fracture model created tibial plafond fracture patterns with similar fracture morphology as human patients without violation of the soft tissue structures or adjacent joints. This model would allow for anatomic fixation, the study of post-traumatic osteoarthritis, or the delivery of locally targeted therapeutics to the ankle joint.
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Affiliation(s)
- Graham J DeKeyser
- University of Washington Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, WA, USA
| | - Tyler Thorne
- University of Utah Department of Orthopaedic Surgery, Salt Lake City, UT, USA
| | - Aaron Olsen
- Utah State University Laboratory Animal Medicine, Logan, UT, USA
| | - Justin M Haller
- University of Utah Department of Orthopaedic Surgery, Salt Lake City, UT, USA.
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2
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Alentado VJ, Knox AM, Staut CA, McGuire AC, Chitwood JR, Mostardo SL, Shaikh MZ, Blosser RJ, Dadwal UC, Chu TMG, Collier CD, Li J, Liu Z, Kacena MA, Natoli RM. Validation of the modified radiographic union score for tibia fractures (mRUST) in murine femoral fractures. Front Endocrinol (Lausanne) 2022; 13:911058. [PMID: 35992150 PMCID: PMC9381990 DOI: 10.3389/fendo.2022.911058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Bony union is a primary predictor of outcome after surgical fixation of long bone fractures. Murine models offer many advantages in assessing bony healing due to their low costs and small size. However, current fracture recovery investigations in mice frequently rely on animal sacrifice and costly analyses. The modified Radiographic Union Score for Tibia fractures (mRUST) scoring system is a validated metric for evaluating bony healing in humans utilizing plain radiographs, which are relatively inexpensive and do not require animal sacrifice. However, its use has not been well established in murine models. The aim of this study was to characterize the longitudinal course of mRUST and compare mRUST to other conventional murine fracture analyses. 158 mice underwent surgically created midshaft femur fractures. Mice were evaluated after fracture creation and at 7, 10, 14, 17, 21, 24, 28, 35, and 42 days post-injury. mRUST scoring of plain radiographs was performed by three orthopaedic surgeons in a randomized, blinded fashion. Interrater correlations were calculated. Micro-computed tomography (μCT) was analyzed for tissue mineral density (TMD), total callus volume (TV), bone volume (BV), trabecular thickness, trabecular number, and trabecular separation. Histomorphometry measures of total callus area, cartilage area, fibrous tissue area, and bone area were performed in a blinded fashion. Ultimate torque, stiffness, toughness, and twist to failure were calculated from torque-twist curves. A sigmoidal log-logistic curve fit was generated for mRUST scores over time which shows mRUST scores of 4 to 6 at 7 days post-injury that improve to plateaus of 14 to 16 by 24 days post-injury. mRUST interrater correlations at each timepoint ranged from 0.51 to 0.86, indicating substantial agreement. mRUST scores correlated well with biomechanical, histomorphometry, and μCT parameters, such as ultimate torque (r=0.46, p<0.0001), manual stiffness (r=0.51, p<0.0001), bone percentage based on histomorphometry (r=0.86, p<0.0001), cartilage percentage (r=-0.87, p<0.0001), tissue mineral density (r=0.83, p<0.0001), BV/TV based on μCT (r=0.65, p<0.0001), and trabecular thickness (r=0.78, p<0.0001), among others. These data demonstrate that mRUST is reliable, trends temporally, and correlates to standard measures of murine fracture healing. Compared to other measures, mRUST is more cost-effective and non-terminal. The mRUST log-logistic curve could be used to characterize differences in fracture healing trajectory between experimental groups, enabling high-throughput analysis.
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Affiliation(s)
- Vincent J. Alentado
- Department of Neurological Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Adam M. Knox
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Caio A. Staut
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Anthony C. McGuire
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Joseph R. Chitwood
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Sarah L. Mostardo
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Mustufa Z. Shaikh
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Rachel J. Blosser
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Usashi C. Dadwal
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Tien-Min Gabriel Chu
- Department of Biomedical Sciences and Comprehensive Care, School of Dentistry, Indiana University, Indianapolis, IN, United States
| | - Christopher D. Collier
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Jiliang Li
- Department of Biology, Indiana University, Purdue University, Indianapolis, IN, United States
| | - Ziyue Liu
- Department of Biostatistics and Health Data Science, School of Public Health, Indiana University, Indianapolis, IN, United States
| | - Melissa A. Kacena
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
- Richard L. Roudebush VA Medical Center, Department of Veterans Affairs, Indianapolis, IN, United States
| | - Roman M. Natoli
- Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN, United States
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Lowen GB, Garrett KA, Moore-Lotridge SN, Uppuganti S, Guelcher SA, Schoenecker JG, Nyman JS. Effect of Intramedullary Nailing Patterns on Interfragmentary Strain in a Mouse Femur Fracture: A Parametric Finite Element Analysis. J Biomech Eng 2022; 144:051007. [PMID: 34802060 PMCID: PMC8822464 DOI: 10.1115/1.4053085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/17/2021] [Indexed: 11/08/2022]
Abstract
Delayed long bone fracture healing and nonunion continue to be a significant socioeconomic burden. While mechanical stimulation is known to be an important determinant of the bone repair process, understanding how the magnitude, mode, and commencement of interfragmentary strain (IFS) affect fracture healing can guide new therapeutic strategies to prevent delayed healing or nonunion. Mouse models provide a means to investigate the molecular and cellular aspects of fracture repair, yet there is only one commercially available, clinically-relevant, locking intramedullary nail (IMN) currently available for studying long bone fractures in rodents. Having access to alternative IMNs would allow a variety of mechanical environments at the fracture site to be evaluated, and the purpose of this proof-of-concept finite element analysis study is to identify which IMN design parameters have the largest impact on IFS in a murine transverse femoral osteotomy model. Using the dimensions of the clinically relevant IMN as a guide, the nail material, distance between interlocking screws, and clearance between the nail and endosteal surface were varied between simulations. Of these parameters, changing the nail material from stainless steel (SS) to polyetheretherketone (PEEK) had the largest impact on IFS. Reducing the distance between the proximal and distal interlocking screws substantially affected IFS only when nail modulus was low. Therefore, IMNs with low modulus (e.g., PEEK) can be used alongside commercially available SS nails to investigate the effect of initial IFS or stability on fracture healing with respect to different biological conditions of repair in rodents.
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Affiliation(s)
- Gregory B. Lowen
- Vanderbilt University, Department of Chemical and Biomolecular Engineering, 2201 West End Ave, Nashville, TN 37235
| | - Katherine A. Garrett
- Vanderbilt University Medical Center, Department of Orthopaedic Surgery, 1215 21 Ave. S., Suite 4200, Nashville, TN 37232
| | - Stephanie N. Moore-Lotridge
- Vanderbilt University Medical Center, Department of Orthopaedic Surgery, 1215 21 Ave. S., Suite 4200, Nashville, TN 37232;Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, 1211 Medical Center Dr., Nashville, TN 37212
| | - Sasidhar Uppuganti
- Vanderbilt University Medical Center, Department of Orthopaedic Surgery, 1215 21 Ave. S., Suite 4200, Nashville, TN 37232;Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, 1211 Medical Center Dr., Nashville, TN 37212
| | - Scott A. Guelcher
- Vanderbilt University, Department of Chemical and Biomolecular Engineering, 2201 West End Ave, Nashville, TN 37235; Vanderbilt University, Department of Biomedical Engineering, 5824 Stevenson Center, Nashville, TN 37232; Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, 1211 Medical Center Dr., Nashville, TN 37212; Vanderbilt University Medical Center, Division of Clinical Pharmacology, 1211 Medical Center Dr, Nashville, TN 37217
| | - Jonathan G. Schoenecker
- Vanderbilt University, Department of Pharmacology, 465 21 Ave South, 7124 Medical Research Building III, Nashville, TN 37232; Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, 1211 Medical Center Dr., Nashville, TN 37212; Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, 1161 21 Ave S C-3322 Medical Center North, Nashville, TN 37232; Vanderbilt University Medical Center, Department of Pediatrics, 2200 Children's Way, Suite 2404, Nashville, TN 37232
| | - Jeffry S. Nyman
- Vanderbilt University, Department of Biomedical Engineering, 5824 Stevenson Center, Nashville, TN 37232; Vanderbilt University Medical Center, Department of Orthopaedic Surgery, 1215 21 Ave. S., Suite 4200, Nashville, TN 37232; Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, 1211 Medical Center Dr., Nashville, TN 37212; Tennessee Valley Healthcare System, Department of Veterans Affairs, 1310 24 Ave. S, Nashville, TN 37212
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4
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Fracture Healing Research-Shift towards In Vitro Modeling? Biomedicines 2021; 9:biomedicines9070748. [PMID: 34203470 PMCID: PMC8301383 DOI: 10.3390/biomedicines9070748] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/18/2021] [Accepted: 06/23/2021] [Indexed: 01/07/2023] Open
Abstract
Fractures are one of the most frequently occurring traumatic events worldwide. Approximately 10% of fractures lead to bone healing disorders, resulting in strain for affected patients and enormous costs for society. In order to shed light into underlying mechanisms of bone regeneration (habitual or disturbed), and to develop new therapeutic strategies, various in vivo, ex vivo and in vitro models can be applied. Undeniably, in vivo models include the systemic and biological situation. However, transferability towards the human patient along with ethical concerns regarding in vivo models have to be considered. Fostered by enormous technical improvements, such as bioreactors, on-a-chip-technologies and bone tissue engineering, sophisticated in vitro models are of rising interest. These models offer the possibility to use human cells from individual donors, complex cell systems and 3D models, therefore bridging the transferability gap, providing a platform for the introduction of personalized precision medicine and finally sparing animals. Facing diverse processes during fracture healing and thus various scientific opportunities, the reliability of results oftentimes depends on the choice of an appropriate model. Hence, we here focus on categorizing available models with respect to the requirements of the scientific approach.
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5
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Kegelman CD, Nijsure MP, Moharrer Y, Pearson HB, Dawahare JH, Jordan KM, Qin L, Boerckel JD. YAP and TAZ Promote Periosteal Osteoblast Precursor Expansion and Differentiation for Fracture Repair. J Bone Miner Res 2021; 36:143-157. [PMID: 32835424 PMCID: PMC7988482 DOI: 10.1002/jbmr.4166] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/10/2020] [Accepted: 07/30/2020] [Indexed: 12/20/2022]
Abstract
In response to bone fracture, periosteal progenitor cells proliferate, expand, and differentiate to form cartilage and bone in the fracture callus. These cellular functions require the coordinated activation of multiple transcriptional programs, and the transcriptional regulators Yes-associated protein (YAP) and transcriptional co-activator with PDZ-binding motif (TAZ) regulate osteochondroprogenitor activation during endochondral bone development. However, recent observations raise important distinctions between the signaling mechanisms used to control bone morphogenesis and repair. Here, we tested the hypothesis that YAP and TAZ regulate osteochondroprogenitor activation during endochondral bone fracture healing in mice. Constitutive YAP and/or TAZ deletion from Osterix-expressing cells impaired both cartilage callus formation and subsequent mineralization. However, this could be explained either by direct defects in osteochondroprogenitor differentiation after fracture or by developmental deficiencies in the progenitor cell pool before fracture. Consistent with the second possibility, we found that developmental YAP/TAZ deletion produced long bones with impaired periosteal thickness and cellularity. Therefore, to remove the contributions of developmental history, we next generated adult onset-inducible knockout mice (using Osx-CretetOff ) in which YAP and TAZ were deleted before fracture but after normal development. Adult onset-induced YAP/TAZ deletion had no effect on cartilaginous callus formation but impaired bone formation at 14 days post-fracture (dpf). Earlier, at 4 dpf, adult onset-induced YAP/TAZ deletion impaired the proliferation and expansion of osteoblast precursor cells located in the shoulder of the callus. Further, activated periosteal cells isolated from this region at 4 dpf exhibited impaired osteogenic differentiation in vitro upon YAP/TAZ deletion. Finally, confirming the effects on osteoblast function in vivo, adult onset-induced YAP/TAZ deletion impaired bone formation in the callus shoulder at 7 dpf before the initiation of endochondral ossification. Together, these data show that YAP and TAZ promote the expansion and differentiation of periosteal osteoblast precursors to accelerate bone fracture healing. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Christopher D Kegelman
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Madhura P Nijsure
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Yasaman Moharrer
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Hope B Pearson
- Department of Aerospace and Mechanical Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - James H Dawahare
- Department of Aerospace and Mechanical Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Kelsey M Jordan
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Ling Qin
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Joel D Boerckel
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
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Everding J, Stolberg-Stolberg J, Pützler J, Roßlenbroich S, Ochman S, Raschke M. Extracorporal shock wave therapy for the treatment of arthrodesis non-unions. Arch Orthop Trauma Surg 2020; 140:1191-1200. [PMID: 32036419 DOI: 10.1007/s00402-020-03361-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Non-union is a regular complication of arthrodeses. Standard treatment includes revision surgery with frequent need for re-revision due to persistent non-union. Particularly patients with concomitant diseases are at risk of secondary complications. There is a need for evaluation of alternative treatment options. The aim of this study is to provide first evidence on union-rate and pain course after focussed extracorporeal shock-wave therapy of arthrodesis non-unions. PATIENTS AND METHODS In a retrospective single-centre study, 25 patients with non-union following arthrodesis received one session of focussed extracorporeal shock-wave therapy (energy flux density 0.36 mJ/mm2, 3000 impulses, 23 kV, 4 Hz). Radiographic and clinical results were recorded 6, 12 and 24 weeks after treatment. RESULTS 24 patients were followed-up. After 24 weeks arthrodeses of the hand healed in 80%, of the upper ankle in 50%, of subtalar joint in 27.2% and of the midfoot in 0% of the cases. Pain decreased from 4.8 (± 2.8) points on the visual analogue scale to 3.4 (± 2.3), 2.9 (± 2.5) and 2.4 (± 2.8) points after 6, 12 and 24 weeks, respectively (p < 0.0001). CONCLUSION Our data indicate that the effect of focussed, high-energy shock wave therapy depends on body region and is effective for the treatment of non-unions of the hand as well as for pain relief. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Jens Everding
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany.
| | - Josef Stolberg-Stolberg
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany
| | - Jan Pützler
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany
| | - Steffen Roßlenbroich
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany
| | - Sabine Ochman
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany
| | - Michael Raschke
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany
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Yue S, He H, Li B, Hou T. Hydrogel as a Biomaterial for Bone Tissue Engineering: A Review. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E1511. [PMID: 32752105 PMCID: PMC7466535 DOI: 10.3390/nano10081511] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
Abstract
Severe bone damage from diseases, including extensive trauma, fractures, and bone tumors, cannot self-heal, while traditional surgical treatment may bring side effects such as infection, inflammation, and pain. As a new biomaterial with controllable mechanical properties and biocompatibility, hydrogel is widely used in bone tissue engineering (BTE) as a scaffold for growth factor transport and cell adhesion. In order to make hydrogel more suitable for the local treatment of bone diseases, hydrogel preparation methods should be combined with synthetic materials with excellent properties and advanced technologies in different fields to better control drug release in time and orientation. It is necessary to establish a complete method to evaluate the hydrogel's properties and biocompatibility with the human body. Moreover, establishment of standard animal models of bone defects helps in studying the therapeutic effect of hydrogels on bone repair, as well as to evaluate the safety and suitability of hydrogels. Thus, this review aims to systematically summarize current studies of hydrogels in BTE, including the mechanisms for promoting bone synthesis, design, and preparation; characterization and evaluation methods; as well as to explore future applications of hydrogels in BTE.
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Affiliation(s)
- Shuai Yue
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
- Key Laboratory of Environment Correlative Dietology, Huazhong Agricultural University, Ministry of Education, Wuhan 43000, China
| | - Hui He
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
- Key Laboratory of Environment Correlative Dietology, Huazhong Agricultural University, Ministry of Education, Wuhan 43000, China
| | - Bin Li
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
- Key Laboratory of Environment Correlative Dietology, Huazhong Agricultural University, Ministry of Education, Wuhan 43000, China
| | - Tao Hou
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
- Key Laboratory of Environment Correlative Dietology, Huazhong Agricultural University, Ministry of Education, Wuhan 43000, China
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8
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Collier CD, Hausman BS, Zulqadar SH, Din ES, Anderson JM, Akkus O, Greenfield EM. Characterization of a reproducible model of fracture healing in mice using an open femoral osteotomy. Bone Rep 2020; 12:100250. [PMID: 32090156 PMCID: PMC7025178 DOI: 10.1016/j.bonr.2020.100250] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/26/2020] [Accepted: 02/03/2020] [Indexed: 01/03/2023] Open
Abstract
Purpose The classic fracture model, described by Bonnarens and Einhorn in 1984, enlists a blunt guillotine to generate a closed fracture in a pre-stabilized rodent femur. However, in less experienced hands, this technique yields considerable variability in fracture pattern and requires highly-specialized equipment. This study describes a reproducible and low-cost model of mouse fracture healing using an open femoral osteotomy. Methods Femur fractures were produced in skeletally mature male and female mice using an open femoral osteotomy after intramedullary stabilization. Mice were recovered for up to 28 days prior to analysis with microradiographs, histomorphometry, a novel μCT methodology, and biomechanical torsion testing at weekly intervals. Results Eight mice were excluded due to complications (8/193, 4.1%), including unacceptable fracture pattern (2/193, 1.0%). Microradiographs showed progression of the fracture site to mineralized callus by 14 days and remodelling 28 days after surgery. Histomorphometry from 14 to 28 days revealed decreased cartilage area and maintained bone area. μCT analysis demonstrated a reduction in mineral surface from 14 to 28 days, stable mineral volume, decreased strut number, and increased strut thickness. Torsion testing at 21 days showed that fractured femurs had 61% of the ultimate torque, 63% of the stiffness, and similar twist to failure when compared to unfractured contralateral femurs. Conclusions The fracture model described herein, an open femoral osteotomy, demonstrated healing comparable to that reported using closed techniques. This simple model could be used in future research with improved reliability and reduced costs compared to the current options. This study characterized a simple and reproducible model of fracture healing in mice using an open femoral osteotomy. Analysis by x-ray, histomorphometry, µCT, and biomechanical testing demonstrated healing comparable to current models. This simple model could be used to increase investigation into fracture healing, delayed union, and non-union.
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Affiliation(s)
- C D Collier
- Department of Orthopaedics, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - B S Hausman
- Department of Orthopaedics, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - S H Zulqadar
- Department of Orthopaedics, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - E S Din
- Department of Orthopaedics, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - J M Anderson
- Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - O Akkus
- Department of Orthopaedics, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA.,Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - E M Greenfield
- Department of Orthopaedics, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA.,Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA
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Johnson JP, Born CT, Thomas N, Truntzer J, Mansuripur PK, Kleiner J, McAlister ST, Garcia D, Koruprolu S. Development of a novel murine femur fracture and fixation model. J Orthop 2020; 17:162-167. [PMID: 31879498 PMCID: PMC6919350 DOI: 10.1016/j.jor.2019.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 06/09/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Animal models have been used for decades to simulate human fractures in the laboratory setting. Fracture models in mice are attractive because they offer a high volume, relatively low-cost method of investigating fracture healing characteristics. We report on the development of a novel murine femur fracture model that is rapid, reproducible and inexpensive. METHODS As part of a pilot study to investigate the effects of smoking on fracture healing, fifteen 35-43 g twelve-week old female CD-1 mice underwent a novel surgical protocol using direct visualization of femur fracture creation and fixation. Following surgery, mice were sacrificed at 14 days, 28 days and 42 days. After sacrifice, the femora were analyzed using MicroCT and histology to evaluate progression of healing. RESULTS Of the 14 mice that survived the surgical procedure (one succumbed to a complication of anesthesia), two lost reduction and did not heal. Histology demonstrated at 14 days 44.1% (SD±2.9%) of callus composed of cartilage. At 28 days there was 19.0% (SD±3.4%) of callus composed of cartilage. At 42 days there was 8.4% (SD±2.6%) callus composed of cartilage (p < 0.005). MicroCT demonstrated that from 14 to 42 days the average callus volume decreased from 101.6 mm3 to 68.2 mm3 while the relative bone volume of callus increased from 14 to 42 days (15%-31%) (p = 0.068). CONCLUSIONS Our novel fracture and fixation model is an effective, rapid, reproducible and inexpensive method to simulate a fracture in a laboratory setting. Additionally, our model reliably creates a reproducible progression of radiographic and histological bone healing.
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Affiliation(s)
- Joey P. Johnson
- Department of Orthopedic Surgery, Loma Linda University, 11406 Loma Linda Drive, Suite 128, Loma Linda, CA, 92354, USA
| | - Christopher T. Born
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI, 593 Eddy Street, Providence, RI, 02903, USA
| | - Nathan Thomas
- Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI, 02912, USA
| | - Jeremy Truntzer
- Department of Orthopedic Surgery, Stanford University, 291 University Drive, Stanford, CA, 94305, USA
| | - P. Kaveh Mansuripur
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI, 593 Eddy Street, Providence, RI, 02903, USA
| | - Justin Kleiner
- Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI, 02912, USA
| | - Scott T. McAlister
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI, 593 Eddy Street, Providence, RI, 02903, USA
| | - Dioscaris Garcia
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI, 593 Eddy Street, Providence, RI, 02903, USA
| | - Sarath Koruprolu
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, RI, 593 Eddy Street, Providence, RI, 02903, USA
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Juhl O, Zhao N, Merife AB, Cohen D, Friedman M, Zhang Y, Schwartz Z, Wang Y, Donahue H. Aptamer-Functionalized Fibrin Hydrogel Improves Vascular Endothelial Growth Factor Release Kinetics and Enhances Angiogenesis and Osteogenesis in Critically Sized Cranial Defects. ACS Biomater Sci Eng 2019; 5:6152-6160. [PMID: 32190730 PMCID: PMC7079287 DOI: 10.1021/acsbiomaterials.9b01175] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
An aging population, decreased activity levels and increased combat injuries, have led to an increase in critical sized bone defects. As more defects are treated using allografts, which is the current standard of care, the deficiencies of allografts are becoming more evident. Allografts lack the angiogenic potential to induce sufficient vasculogenesis to counteract the hypoxic environment associated with critical sized bone defects. In this study, aptamer-functionalized fibrin hydrogels (AFH), engineered to release vascular endothelial growth factor (VEGF), were evaluated for their material properties, growth factor release kinetics, and angiogenic and osteogenic potential in vivo. Aptamer functionalization to native fibrin did not result in significant changes in biocompatibility or hydrogel gelation. However, aptamer functionalization of fibrin did improve the release kinetics of VEGF from AFH and, when compared to FH, reduced the diffusivity and extended the release of VEGF several days longer. VEGF released from AFH, in vivo, increased vascularization to a greater degree, relative to VEGF released from FH, in a murine critical-sized cranial defect. Defects treated with AFH loaded with VEGF, relative to nonhydrogel loaded controls, showed a nominal increase in osteogenesis. Together, these data suggest that AFH more efficiently incorporates and retains VEGF in vitro and in vivo, which then enhances angiogenesis and osteogenesis to a greater extent in vivo than FH.
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Affiliation(s)
- Otto Juhl
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Nan Zhao
- Department of Biomedical Engineering, Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Anna-Blessing Merife
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - David Cohen
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Michael Friedman
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Yue Zhang
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Zvi Schwartz
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Yong Wang
- Department of Biomedical Engineering, Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Henry Donahue
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia 23220, United States
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11
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Fitschen-Oestern S, Lippross S, Klueter T, Weuster M, Varoga D, Tohidnezhad M, Pufe T, Rose-John S, Andruszkow H, Hildebrand F, Steubesand N, Seekamp A, Neunaber C. A new multiple trauma model of the mouse. BMC Musculoskelet Disord 2017; 18:468. [PMID: 29157219 PMCID: PMC5697084 DOI: 10.1186/s12891-017-1813-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 11/06/2017] [Indexed: 01/07/2023] Open
Abstract
Background Blunt trauma is the most frequent mechanism of injury in multiple trauma, commonly resulting from road traffic collisions or falls. Two of the most frequent injuries in patients with multiple trauma are chest trauma and extremity fracture. Several trauma mouse models combine chest trauma and head injury, but no trauma mouse model to date includes the combination of long bone fractures and chest trauma. Outcome is essentially determined by the combination of these injuries. In this study, we attempted to establish a reproducible novel multiple trauma model in mice that combines blunt trauma, major injuries and simple practicability. Methods Ninety-six male C57BL/6 N mice (n = 8/group) were subjected to trauma for isolated femur fracture and a combination of femur fracture and chest injury. Serum samples of mice were obtained by heart puncture at defined time points of 0 h (hour), 6 h, 12 h, 24 h, 3 d (days), and 7 d. Results A tendency toward reduced weight and temperature was observed at 24 h after chest trauma and femur fracture. Blood analyses revealed a decrease in hemoglobin during the first 24 h after trauma. Some animals were killed by heart puncture immediately after chest contusion; these animals showed the most severe lung contusion and hemorrhage. The extent of structural lung injury varied in different mice but was evident in all animals. Representative H&E-stained (Haematoxylin and Eosin-stained) paraffin lung sections of mice with multiple trauma revealed hemorrhage and an inflammatory immune response. Plasma samples of mice with chest trauma and femur fracture showed an up-regulation of IL-1β (Interleukin-1β), IL-6, IL-10, IL-12p70 and TNF-α (Tumor necrosis factor- α) compared with the control group. Mice with femur fracture and chest trauma showed a significant up-regulation of IL-6 compared to group with isolated femur fracture. Conclusions The multiple trauma mouse model comprising chest trauma and femur fracture enables many analogies to clinical cases of multiple trauma in humans and demonstrates associated characteristic clinical and pathophysiological changes. This model is easy to perform, is economical and can be used for further research examining specific immunological questions.
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Affiliation(s)
- Stefanie Fitschen-Oestern
- Department of Trauma Surgery, University Medical Center of Schleswig-Holstein, Arnold-Heller Straße 7, 24105, Campus Kiel, Kiel, Germany.
| | - Sebastian Lippross
- Department of Trauma Surgery, University Medical Center of Schleswig-Holstein, Arnold-Heller Straße 7, 24105, Campus Kiel, Kiel, Germany
| | - Tim Klueter
- Department of Trauma Surgery, University Medical Center of Schleswig-Holstein, Arnold-Heller Straße 7, 24105, Campus Kiel, Kiel, Germany
| | - Matthias Weuster
- Department of Trauma Surgery, University Medical Center of Schleswig-Holstein, Arnold-Heller Straße 7, 24105, Campus Kiel, Kiel, Germany
| | - Deike Varoga
- Department of Trauma Surgery, University Medical Center of Schleswig-Holstein, Arnold-Heller Straße 7, 24105, Campus Kiel, Kiel, Germany
| | - Mersedeh Tohidnezhad
- Department of Anatomy and Cell Biology, RWTH Aachen University, Wendlingweg 2, D-52074, Aachen, Germany
| | - Thomas Pufe
- Department of Anatomy and Cell Biology, RWTH Aachen University, Wendlingweg 2, D-52074, Aachen, Germany
| | - Stefan Rose-John
- Department of Biochemistry, Medical Faculty, Olshausenstr. 40, 24098, Kiel, Germany
| | - Hagen Andruszkow
- Department of Trauma Surgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Frank Hildebrand
- Department of Trauma Surgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Nadine Steubesand
- Department of Trauma Surgery, University Medical Center of Schleswig-Holstein, Arnold-Heller Straße 7, 24105, Campus Kiel, Kiel, Germany
| | - Andreas Seekamp
- Department of Trauma Surgery, University Medical Center of Schleswig-Holstein, Arnold-Heller Straße 7, 24105, Campus Kiel, Kiel, Germany
| | - Claudia Neunaber
- Department of Trauma Surgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
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12
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Li WL, Yu X, Huang ZP, Pang QJ. Effect of parathyroid hormone on healing in osteoporotic fractures via a phospholipase C-independent pathway. J Int Med Res 2017; 45:1200-1207. [PMID: 28534698 PMCID: PMC5536420 DOI: 10.1177/0300060517707075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objective This study was performed to investigate the effect of parathyroid hormone (PTH) on healing in osteoporotic fractures via a phospholipase C (PLC)-independent pathway and explore the mechanism of PTH-mediated bone formation. Methods Ninety-six 12-week-old C57BL/6J female mice underwent bilateral ovariectomy. One month later, the lower third of the femur was fractured and the mice were treated using saline, PTH(1-28), PTH(1-34), zoledronic acid (ZA), PTH(1-28)+ZA, and PTH(1-34)+ZA. The mice were killed at weeks 2 and 4 in each group. Biomechanical testing and micro-computed tomography were performed. Results The formation and strength of the callus increased in all but the saline group. The mice treated with PTH(1-34) showed a significantly higher ultimate bending force, bending rigidity, bone mineral density, percent bone volume, and trabecular thickness than those treated with PTH(1-28). The PTH(1-34)+ZA group demonstrated the greatest improvements in the ultimate bending force, bending rigidity, bone mineral density, and relative bone volume. Conclusions PTH can promote fracture healing and callus hardness in ovariectomized mice by increasing callus formation and reconstructing trabecular bone via a PLC-independent pathway. PTH combined with ZA has a cumulative effect on the healing of fractures in ovariectomized mice.
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Affiliation(s)
- Wei-Long Li
- 1 Ningbo University School of Medicine, Ningbo, China
| | - Xiao Yu
- 2 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
| | - Zhi-Ping Huang
- 3 Department of Spinal Surgery, Nanfang Hospital, Southern University, Guangzhou, China
| | - Qing-Jiang Pang
- 2 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
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13
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Histing T, Andonyan A, Klein M, Scheuer C, Stenger D, Holstein JH, Veith NT, Pohlemann T, Menger MD. Obesity does not affect the healing of femur fractures in mice. Injury 2016; 47:1435-44. [PMID: 27156834 DOI: 10.1016/j.injury.2016.04.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 04/15/2016] [Accepted: 04/21/2016] [Indexed: 02/02/2023]
Abstract
Obesity is reported to be both protective and deleterious to bone. Lipotoxicity and inflammation might be responsible for bone loss through inhibition of osteoblasts and activation of osteoclasts. However, little is known whether obesity affects the process of fracture healing. Therefore, we studied the effect of high fat diet-induced (HFD) obesity on callus formation and bone remodelling in a closed femur fracture model in mice. Thirty-one mice were fed a diet containing 60kJ% fat (HFD) for a total of 20 weeks before fracture and during the entire postoperative observation period. Control mice (n=31) received a standard diet containing 10kJ% fat. Healing was analyzed using micro-CT, biomechanical, histomorphometrical, immunohistochemical, serum and protein biochemical analysis at 2 and 4 weeks after fracture. HFD-fed mice showed a higher body weight and increased serum concentrations of leptin and interleukin-6 compared to controls. Within the callus tissue Western blot analyses revealed a higher expression of transcription factor peroxisome proliferator-activated receptor y (PPARy) and a reduced expression of runt-related transcription factor 2 (RUNX2) and bone morphogenetic protein (BMP)-4. However, obesity did not affect the expression of BMP-2 and did not influence the receptor activator of nuclear factor κB (RANK)/RANK ligand/osteoprotegerin (OPG) pathway during fracture healing. Although the bones of HFD-fed animals showed an increased number of adipocytes within the bone marrow, HFD did not increase callus adiposity. In addition, radiological and histomorphometric analysis could also not detect significant differences in bone formation between HFD-fed animals and controls. Accordingly, HFD did not affect bending stiffness after 2 and 4 weeks of healing. These findings indicate that obesity does not affect femur fracture healing in mice.
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Affiliation(s)
- T Histing
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany.
| | - A Andonyan
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany
| | - M Klein
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany
| | - C Scheuer
- Institute for Clinical & Experimental Surgery, University of Saarland, Homburg/Saar, Germany
| | - D Stenger
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany
| | - J H Holstein
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany
| | - N T Veith
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany
| | - T Pohlemann
- Department of Trauma, Hand and Reconstructive Surgery, University of Saarland, Homburg/Saar, Germany
| | - M D Menger
- Institute for Clinical & Experimental Surgery, University of Saarland, Homburg/Saar, Germany
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14
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Haffner-Luntzer M, Kovtun A, Rapp AE, Ignatius A. Mouse Models in Bone Fracture Healing Research. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s40610-016-0037-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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15
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Histing T, Heerschop K, Klein M, Scheuer C, Stenger D, Herath SC, Pohlemann T, Menger MD. Effect of Stabilization on the Healing Process of Femur Fractures in Aged Mice. J INVEST SURG 2016; 29:202-8. [PMID: 26891453 DOI: 10.3109/08941939.2015.1127448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The influence of mechanical stability on fracture healing has previously been studied in adult mice, but is poorly understood in aged animals. Therefore, we herein studied the effect of stabilization on the healing process of femur fractures in aged mice. METHODS Twenty-four 18-month-old CD-1 mice were stabilized after midshaft fracture of the femur with an intramedullary screw. In another 24 18-month-old mice, the femur fractures were left unstabilized. Bone healing was studied by radiological, biomechanical, histomorphometric, and protein expression analyses. RESULTS After 2 and 5 weeks of healing, the callus of nonstabilized fractures compared to stabilized fractures was significantly larger, containing a significantly smaller amount of osseous tissue and a higher amount of cartilaginous tissue. This was associated with a significantly lower biomechanical stiffness during the early phase of healing. However, during the late phase of fracture healing both nonstabilized and stabilized fractures showed a biomechanical stiffness of ∼40%. Of interest, Western blot analyses of callus tissue demonstrated that the expression of proteins related to angiogenesis, bone formation and remodeling, i.e. VEGF, CYR61, BMP-2, BMP-4, Col-2, Col-10, RANKL, OPG, did not differ between nonstabilized and stabilized fractures. CONCLUSION Nonstabilized fractures in aged mice show delayed healing and remodeling. This is not caused by an altered protein expression in the callus but rather by the excessive interfragmentary movements.
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Affiliation(s)
- T Histing
- a Department of Trauma, Hand and Reconstructive Surgery , Saarland University , D-66421 Homburg/Saar, Germany
| | - K Heerschop
- a Department of Trauma, Hand and Reconstructive Surgery , Saarland University , D-66421 Homburg/Saar, Germany
| | - M Klein
- a Department of Trauma, Hand and Reconstructive Surgery , Saarland University , D-66421 Homburg/Saar, Germany
| | - C Scheuer
- b Institute for Clinical & Experimental Surgery , Saarland University , Homburg/Saar, Germany
| | - D Stenger
- a Department of Trauma, Hand and Reconstructive Surgery , Saarland University , D-66421 Homburg/Saar, Germany
| | - S C Herath
- a Department of Trauma, Hand and Reconstructive Surgery , Saarland University , D-66421 Homburg/Saar, Germany
| | - T Pohlemann
- a Department of Trauma, Hand and Reconstructive Surgery , Saarland University , D-66421 Homburg/Saar, Germany
| | - M D Menger
- b Institute for Clinical & Experimental Surgery , Saarland University , Homburg/Saar, Germany
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