Determining the critical size of a rabbit rib segmental bone defect model

Dynamic Transcriptome Analysis of SFRP Family in Guided Bone Regeneration With Occlusive Periosteum in Swine Model

BACKGROUND

A variety of congenital or acquired conditions can cause craniomaxillofacial bone defects, resulting in a heavy financial burden and psychological stress. Guided bone self-generation with periosteum-preserved has great potential for reconstructing large bone defects.

METHODS

A swine model of guided bone regeneration with occlusive periosteum was established, the rib segment was removed, and the periosteum was sutured to form a closed regeneration chamber. Hematoxylin and eosin staining, Masson's staining, and Safranine O-Fast Green staining were done. Nine-time points were chosen for collecting the periosteum and regenerated bone tissue for gene sequencing. The expression level of each secreted frizzled-related protein (SFRP) member and the correlations among them were analyzed.

RESULTS

The process of bone regeneration is almost complete 1 month after surgery, and up to 1 week after surgery is an important interval for initiating the process. The expression of each SFRP family member fluctuated greatly. The highest expression level of all members ranged from 3 days to 3 months after surgery. The expression level of SFRP2 was the highest, and the difference between 2 groups was the largest. Secreted frizzled-related protein 2 and SFRP4 showed a notable positive correlation between the control and model groups. Secreted frizzled-related protein 1, SFRP2, and SFRP4 had a significant spike in fold change at 1 month postoperatively. Secreted frizzled-related protein 1 and SFRP2 had the strongest correlation.

CONCLUSIONS

This study revealed the dynamic expression of the SFRP family in guided bone regeneration with occlusive periosteum in a swine model, providing a possibility to advance the clinical application of bone defect repair.

Progress of Periosteal Osteogenesis: The Prospect of In Vivo Bioreactor

Repairing large segment bone defects is still a clinical challenge. Bone tissue prefabrication shows great translational potentials and has been gradually accepted clinically. Existing bone reconstruction strategies, including autologous periosteal graft, allogeneic periosteal transplantation, xenogeneic periosteal transplantation, and periosteal cell tissue engineering, are all clinically valuable treatments and have made significant progress in research. Herein, we reviewed the research progress of these techniques and briefly explained the relationship among in vivo microenvironment, mechanical force, and periosteum osteogenesis. Moreover, we also highlighted the importance of the critical role of periosteum in osteogenesis and explained current challenges and future perspective.

Effects of Combination of BMP7, PFG, and Autograft on Healing of the Experimental Critical Radial Bone Defect by Induced Membrane (Masquelet) Technique in Rabbit

Background

Healing of large segmental bone defects can be challenging for orthopedic surgeons. This research was conducted to provide further insight into the effects of BMP7 in combination with autograft and platelet fibrin glue (PFG) on bone regeneration by Masquelet technique (MT).

Methods

Twenty five domestic male rabbits, more than 6 months old, weighing 2.00±0.25 kg were randomly divided into five equal groups as follows: MT-blank cavity (without any biological or synthetic materials) (1), blank cavity (2), MT-autograft (3), MT-autograft-BMP7 (4), and MT-BMP7-PFG (5). A 20 mm segmental defect was made in radial bone in both forelimbs. The Masquelet technique was done in all groups except group 2. The study was evaluated by radiology, biomechanics, histopathology and scanning electron microscopy.

Results

The results showed that Masquelet technique enhanced the healing process, as, the structural and functional criteria of the injured bone showed significantly improved bone healing (P<0.05). Treatment by PFG-BMP7, Autograft-BMP7, and autograft demonstrated beneficial effects on bone healing. However, Autograft-BMP7 was more effective than autograft in healing of the radial defect in rabbits.

Conclusion

Our findings introduce the osteogenic materials in combination with Masquelet technique as an alternative for reconstruction of the big diaphyseal defects in the long bones in animal models. Our findings may be useful for clinical application in future.

An overview of de novo bone generation in animal models

Some of the earliest success in de novo tissue generation was in bone tissue, and advances, facilitated by the use of endogenous and exogenous progenitor cells, continue unabated. The concept of one health promotes shared discoveries among medical disciplines to overcome health challenges that afflict numerous species. Carefully selected animal models are vital to development and translation of targeted therapies that improve the health and well-being of humans and animals alike. While inherent differences among species limit direct translation of scientific knowledge between them, rapid progress in ex vivo and in vivo de novo tissue generation is propelling revolutionary innovation to reality among all musculoskeletal specialties. This review contains a comparison of bone deposition among species and descriptions of animal models of bone restoration designed to replicate a multitude of bone injuries and pathology, including impaired osteogenic capacity.

Autogenous bone particles combined with platelet-rich plasma can stimulate bone regeneration in rabbits

Long-term bone defects are a key clinical problem. Autogenous bone graft remains the gold standard for the treatment of these defects; however, improving the osteogenic properties and reducing the amount of autogenous bone is challenging. Autologous platelet-rich plasma (PRP) has been widely considered for treatment, due to its potentially beneficial effect on bone regeneration and vascularization. The aim of the present study was to explore the effects of autogenous bone particles combined with PRP on repairing segmental bone defects in rabbits. Briefly, a critical-size diaphyseal radius defect was established in 45 New Zealand White rabbits. Animals were randomly divided into four groups, according to the different implants: Group A, empty bone defect; group B, PRP; group C, autogenous bone particles + bone mesenchymal stem cells (BMSCs) on the left radius; group D, autogenous bone particles + PRP + BMSCs on the right radius. Bone samples were collected and further analyzed using X-ray, histology and histomorphometry 4, 8 and 12 weeks post-surgery. In addition, the effect of PRP on cell proliferation was detected by Cell Counting Kit-8 and the concentrations of growth factors (GFs), transforming GF (TGF)-β1 and platelet-derived GF (PDGF), in PRP were verified by ELISA. X-ray, histology and histomorphometry data revealed that the fraction area of the newly formed bone was larger in group D. In addition, PRP could improve cell proliferation, osteogenic differentiation and the release of GFs, TGF-β1 and PDGF-AB. In conclusion, these findings indicated that an autogenous bone particle + PRP + BMSC scaffold may be used as a potential treatment strategy for segmental defects in humans.

Guided Bone Regeneration with Ammoniomethacrylate-Based Barrier Membranes in a Radial Defect Model

Large bone defects pose an unsolved challenge for orthopedic surgeons. Our group has previously reported the construction of a barrier membrane made of ammoniomethacrylate copolymer USP (AMCA), which supports the adhesion, proliferation, and osteoblastic differentiation of human mesenchymal stem cells (hMSCs). In this study, we report the use of AMCA membranes to seclude critical segmental defect (~1.0 cm) created in the middle third of rabbit radius and test the efficiency of bone regeneration. Bone regeneration was assessed by radiography, biweekly for 8 weeks. The results were verified by histology and micro-CT at the end of the follow-up. The AMCA membranes were found superior to no treatment in terms of new bone formation in the defect, bone volume, callus surface area normalized to total volume, and the number of bone trabeculae, after eight weeks. Additional factors were then assessed, and these included the addition of simvastatin to the membrane, coating the membrane with human MSC, and a combination of those. The addition of simvastatin to the membranes demonstrated a stronger effect at a similar radiological follow-up. We conclude that AMCA barrier membranes per se and simvastatin delivered in a controlled manner improve bone regeneration outcome.

Guided bone regeneration by the development of alendronate sodium loaded in-situ gel and membrane formulations

Biocompatible materials applied in guided bone regeneration are needed to prevent leakage caused by the invasion of peripheral epithelium. (2.1) The aim of this study is to develop a thermosensitive in situ gel system containing alendronate sodium loaded PLGA nanoparticles and alendronate sodium loaded membranes for guided bone regeneration. Thermosensitive Pluronic F127 gel system was preferred to prevent soft tissue migration to the defect site and prolong the residence time of the nanoparticles in this region. In situ gel system was combined with membrane formulation to enhance bone regenaration activity. Efficacy of combination system was investigated by implanting in 0.5 × 0.5 cm critical size defect in tibia of New Zealand female rabbits. According to the histopathological results, fibroblast formations were found at defect area after 6 weeks of post implantation. In contrast, treatment with the combination of in-situ gel containing nanoparticles with membrane provided woven bone formation with mature bone after 4 weeks of post implantation. As a results, the combination of in-situ gel formulation containing alendronate sodium-loaded nanoparticles with membrane formulation could be effectively applided for guided bone regeneration.

Survey of In Situ Splitting Rib Harvesting Surgery for Orbital Deformity: Follow-Up

BACKGROUND

Our previous study indicated that in situ splitting rib harvesting surgery clinically reduced in related complications compared with the traditional surgical approach in the early stage, but there are few studies pay close attention to long-term recovery of donor area after rib harvesting. In this study, the authors conducted a follow-up study on recovery condition of donor and graft site of patients after in situ rib splitting grafting or simple whole rib grafting surgery.

METHODS

Between 2013 and 2016, 8 Chinese patients with orbital deformity were corrected using autogenous rib, of which 3 patients received conventional rib harvesting surgery, 3 patients received in situ splitting harvesting surgery, and 2 patients underwent both. In all patients, 3-dimensional computed tomography study of donor site and graft site were performed before and after operation. The ribs of donor site and graft site volume measurement were assessed using computed tomography 7 days and 12 months postoperation.

RESULTS

After 12 months operation, the integrity of rib arch recovered 94.1 ± 2.2% after in situ splitting rib harvesting, compared with 41.4 ± 5.0% after whole rib harvesting. The volume of grafted rib in situ splitting rib harvesting group reduced 69.8 ± 10.0% after 12 months operation compared with the volume after 1 week operation, and the reduced volume of ribs in whole rib harvesting group was 73.62 ± 9.5%.

CONCLUSION

Rib regeneration occurred more quickly by in situ rib splitting harvesting approach compared with the traditional surgical approach.

Comparison of rabbit rib defect regeneration with and without graft

Rib segment, as one of the most widely used autologous boneresources for bone repair, is commonly isolated with an empty left in the defect. Although defective rib repair is thought to be unnecessary traditionally, it's of vital importance actually to promote rib regeneration for patients with better postoperative recovery and higher life quality. Comparative investigations on rabbit rib bone regeneration with and without graft were reported in this article. A segmental defect was performed on the 8th rib of 4-month-old male New Zealand rabbits. The mineralized collagen bone graft (MC) was implanted into the defect and evaluated for up to 12 weeks. The rib bone repair was investigated by using X-ray at 4, 8 and 12 weeks and histological examinations at 12 weeks after surgery, which showed a higher bone remodeling activity in the groups with MC implantation in comparison with blank control group, especially at the early stage of remodeling.