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Söhling N, Von Jan O, Janko M, Nau C, Ritz U, Marzi I, Henrich D, Verboket RD. Measuring Bone Healing: Parameters and Scores in Comparison. Bioengineering (Basel) 2023; 10:1011. [PMID: 37760113 PMCID: PMC10525182 DOI: 10.3390/bioengineering10091011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/05/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Bone healing is a complex process that can not be replicated in its entirety in vitro. Research on bone healing still requires the animal model. The critical size femur defect (CSFD) in rats is a well-established model for fractures in humans that exceed the self-healing potential. New therapeutic approaches can be tested here in vivo. Histological, biomechanical, and radiological parameters are usually collected and interpreted. However, it is not yet clear to what extent they correlate with each other and how necessary it is to record all parameters. (2) Methods: The basis for this study was data from three animal model studies evaluating bone healing. The µCT and histological (Movat pentachrome, osteocalcin) datasets/images were reevaluated and correlation analyses were then performed. Two image processing procedures were compared in the analysis of the image data. (3) Results: There was a significant correlation between the histologically determined bone fraction (Movat pentachrome staining) and bending stiffness. Bone fraction determined by osteocalcin showed no prognostic value. (4) Conclusions: The evaluation of the image datasets using ImageJ is sufficient and simpler than the combination of both programs. Determination of the bone fraction using Movat pentachrome staining allows conclusions to be drawn about the biomechanics of the bone. A standardized procedure with the ImageJ software is recommended for determining the bone proportion.
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Affiliation(s)
- Nicolas Söhling
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.V.J.); (M.J.); (C.N.); (I.M.); (D.H.); (R.D.V.)
| | - Olivia Von Jan
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.V.J.); (M.J.); (C.N.); (I.M.); (D.H.); (R.D.V.)
| | - Maren Janko
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.V.J.); (M.J.); (C.N.); (I.M.); (D.H.); (R.D.V.)
| | - Christoph Nau
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.V.J.); (M.J.); (C.N.); (I.M.); (D.H.); (R.D.V.)
| | - Ulrike Ritz
- Department of Orthopedics and Traumatology, University Hospital, Johannes Gutenberg-University, 55131 Mainz, Germany;
| | - Ingo Marzi
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.V.J.); (M.J.); (C.N.); (I.M.); (D.H.); (R.D.V.)
| | - Dirk Henrich
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.V.J.); (M.J.); (C.N.); (I.M.); (D.H.); (R.D.V.)
| | - René D. Verboket
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (O.V.J.); (M.J.); (C.N.); (I.M.); (D.H.); (R.D.V.)
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Ong JL, Shiels SC, Pearson J, Karajgar S, Miar S, Chiou G, Appleford M, Wenke JC, Guda T. Spatial rhBMP2 delivery from hydroxyapatite scaffolds sustains bone regeneration in rabbit radius. Tissue Eng Part C Methods 2022; 28:363-374. [PMID: 35615881 DOI: 10.1089/ten.tec.2022.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Regenerating large bone defects requires a multi-faceted approach combining optimal scaffold designs with appropriate growth factor delivery. Supraphysiological doses of recombinant human bone morphogenetic protein 2(rhBMP2); typically used for the regeneration of large bone defects clinically in conjunction with an acellular collagen sponge (ACS), have resulted in many complications. In the current study, we develop a hydroxyapatite/collagen I (HA/Col) scaffold to improve the mechanical properties of the HA scaffolds while maintaining open connected porosity. Varying rhBMP2 dosages were then delivered from a collagenous periosteal membrane and paired with HA or HA/Col scaffolds to treat critical sized (15mm) diaphyseal radial defect in New Zealand white rabbits. The groups examined were ACS+76µg rhBMP2 (clinically used INFUSE dosage), HA+76µg rhBMP2, HA+15µg rhBMP2, HA/Col+15µg rhBMP2 and HA/Col+15µg rhBMP2+bone marrow derived stromal cells (bMSCs). After 8 weeks of implantation, all regenerated bones were evaluated using micro computed tomography, histology, histomorphometry and torsional testing. It was observed that the bone volume regenerated in the HA/Col + 15 µg rhBMP2 group was significantly higher than that in the groups with 76µg rhBMP2. The same scaffold and growth factor combination resulted in the highest bone mineral density of the regenerated bone, and the most bone apposition on the scaffold surface. Both the HA and HA/Col scaffolds paired with 15 µg rhBMP2 had sustained ingrowth of the mineralization front after 2 weeks compared to the groups with 76µg rhBMP2 which had far greater mineralization in the first 2 weeks after implantation. Complete bridging of the defect site and no significant differences in torsional strength, stiffness or angle at failure was observed across all groups. No benefit of additional bMSC seeding was observed on any of the quantified metrics, while bone-implant apposition was reduced in the cell seeded group. This study demonstrated that the controlled spatial delivery of rhBMP2 at the periosteum at significantly lower doses can be used as a strategy to improve bone regeneration around space maintaining scaffolds.
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Affiliation(s)
- Joo L Ong
- The University of Texas at San Antonio, 12346, Biomedical Engineering and Chemical Engineering, San Antonio, Texas, United States;
| | - Stefanie C Shiels
- The University of Texas at San Antonio, 12346, Biomedical Engineering and Chemical Engineering, San Antonio, Texas, United States.,US Army Institute of Surgical Research, 110230, Fort Sam Houston, Texas, United States;
| | - Joseph Pearson
- The University of Texas at San Antonio, 12346, Biomedical Engineering and Chemical Engineering, San Antonio, Texas, United States.,Georgia Institute of Technology, 1372, Wallace H Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States;
| | - Suyash Karajgar
- The University of Texas at San Antonio, 12346, Biomedical Engineering and Chemical Engineering, San Antonio, Texas, United States;
| | - Solaleh Miar
- The University of Texas at San Antonio, 12346, Biomedical Engineering and Chemical Engineering, San Antonio, Texas, United States;
| | - Gennifer Chiou
- The University of Texas at San Antonio, 12346, Biomedical Engineering and Chemical Engineering, San Antonio, Texas, United States;
| | - Mark Appleford
- The University of Texas at San Antonio, 12346, Biomedical Engineering and Chemical Engineering, San Antonio, Texas, United States;
| | - Joseph C Wenke
- US Army Institute of Surgical Research, 110230, Fort Sam Houston, Texas, United States.,The University of Texas Medical Branch at Galveston, 12338, Department of Orthopedic Surgery and Rehabilitation, Galveston, Texas, United States;
| | - Teja Guda
- University of Texas at San Antonio, 12346, Biomedical Engineering and Chemical Engineering, San Antonio, Texas, United States;
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Van Erk M, Van Luijk J, Yang F, Leeuwenburgh SCG, Sánchez‐Fernández MJ, Hermans E, Félix Lanao RP, Van Goor H. A systematic review and meta-analyses on animal models used in bone adhesive research. J Orthop Res 2022; 40:624-633. [PMID: 33871061 PMCID: PMC9290478 DOI: 10.1002/jor.25057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 01/19/2021] [Accepted: 04/12/2021] [Indexed: 02/04/2023]
Abstract
Currently, steel implants are used for osteosynthesis of (comminuted) fractures and intra-articular bone defects. These osteosyntheses can sometimes be complicated procedures and can have several drawbacks including stress shielding of the bone. A bone glue might be a safe and effective alternative to current materials. Despite numerous animal studies on bone adhesives, no such material is clinically applied yet. We have conducted a systematic review to summarize the evidence in experimental animal models used in research on bone adhesive materials for trauma and orthopedic surgery. Additionally, we analysed the efficacy of the different bone adhesives for different experimental designs. A heterogeneity in experimental parameters including animal species, defect types, and control measurements resulted in a wide variety in experimental models. In addition, no standard outcome measurements could be identified. Meta-analysis on bone regeneration between adhesive treatment and nonadhesive treatment showed a high heterogeneity and no statistically significant overall effect (M: -0.71, 95% confidence interval [CI]: -1.63-0.21, p = 0.13). Besides, currently there is not enough evidence to draw conclusions based on the effectiveness of the individual types of adhesives or experimental models. A positive statistically significant effect was found for the adhesive treatment in comparison with conventional osteosynthesis materials (M: 2.49, 95% CI: 1.20-3.79, p = 0.0002). To enhance progression in bone adhesive research and provide valuable evidence for clinical application, more standard experimental parameters and a higher reporting quality in animal studies are needed. Statement of Clinical Significance: Current materials restoring anatomical alignments of bones have several drawbacks. A (biodegradable) adhesive for fixating bone defects can be a treatment breakthrough. Although numerous bone adhesives have been researched, most seemed to fail at the preclinical stage. An overview in this field is missing. This systematic review highlights the relevant parameters for design of experimental bone adhesive studies. It demonstrates evidence regarding benefit of bone adhesives but also that the quality of reporting and the risk of bias in studies need to be improved. The results will aid in designing better quality animal studies for bone adhesive research with higher translational value.
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Affiliation(s)
- Machteld Van Erk
- Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands
| | - Judith Van Luijk
- Department for Health Evidence, SYstematic Review Centre for Laboratory Animal Experimentation (SYRCLE)Radboud University Medical CentreNijmegenThe Netherlands
| | - Fang Yang
- Department of Regenerative BiomaterialsRadboud University Medical CentreNijmegenThe Netherlands
| | | | | | - Erik Hermans
- Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands
| | - Rosa P. Félix Lanao
- Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands,GATT Technologies B.V.NijmegenThe Netherlands
| | - Harry Van Goor
- Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands
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Zha K, Tian Y, Panayi AC, Mi B, Liu G. Recent Advances in Enhancement Strategies for Osteogenic Differentiation of Mesenchymal Stem Cells in Bone Tissue Engineering. Front Cell Dev Biol 2022; 10:824812. [PMID: 35281084 PMCID: PMC8904963 DOI: 10.3389/fcell.2022.824812] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/08/2022] [Indexed: 12/12/2022] Open
Abstract
Although bone is an organ that displays potential for self-healing after damage, bone regeneration does not occur properly in some cases, and it is still a challenge to treat large bone defects. The development of bone tissue engineering provides a new approach to the treatment of bone defects. Among various cell types, mesenchymal stem cells (MSCs) represent one of the most promising seed cells in bone tissue engineering due to their functions of osteogenic differentiation, immunomodulation, and secretion of cytokines. Regulation of osteogenic differentiation of MSCs has become an area of extensive research over the past few years. This review provides an overview of recent research progress on enhancement strategies for MSC osteogenesis, including improvement in methods of cell origin selection, culture conditions, biophysical stimulation, crosstalk with macrophages and endothelial cells, and scaffolds. This is favorable for further understanding MSC osteogenesis and the development of MSC-based bone tissue engineering.
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Affiliation(s)
- Kangkang Zha
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Yue Tian
- Department of Military Patient Management, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Institute of Orthopaedics, Chinese PLA General Hospital, Beijing, China
| | - Adriana C. Panayi
- Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Bobin Mi
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
- *Correspondence: Bobin Mi, ; Guohui Liu,
| | - Guohui Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
- *Correspondence: Bobin Mi, ; Guohui Liu,
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