The critical size bony defect in a small animal for bone healing studies (I): Comparative anatomical study on rats' femur / Der kritische Knochendefekt am Kleintier zur Untersuchung der Knochenheilung: Vergleichende Anatomie am Rattenfemur

Precoating of biphasic calcium phosphate bone substitute with atelocollagen enhances bone regeneration through stimulation of osteoclast activation and angiogenesis

Type I collagen (Col) is a naturally polymerizing protein and important extracellular matrix bone component. The aim of this study was to improve bone regeneration capacity by precoating the surface of biphasic calcium phosphate (BCP) granules with AT-Col, and evaluating its biological effects. BCP granules were precoated with AT-Col using adsorption and lyophilization method. Morphology of AT-Col precoated surfaces was observed using scanning electron microscopy (SEM). Biocompatibility and osteogenic activity of AT-Col were determined in vitro with human mesenchymal stem cell (hMSCs). In vivo bone healing efficiency and related biological effects were determined using a rabbit calvarial defect model. SEM results revealed numerous irregularly distributed AT-Col polymer clusters on BCP granule surface. Biocompatibility experiments demonstrated that AT-Col was non-cytotoxic, and that cell proliferation, adhesion, and osteogenic activity were improved by AT-Col precoating. After in vivo surgical implantation into bone defects, new bone formation was improved by AT-Col granule precoating. Specifically, 8 weeks post-surgery, percentage bone volume was significantly higher in AT-Col/BCP animals (35.02 ± 1.89%) compared with BCP-treated animals (8.94 ± 1.47%) (p < 0.05). Furthermore, tartrate-resistant acid phosphatase staining and CD31 immunohistochemical staining revealed that osteoclast activation and new blood vessel formation in vivo were also induced by AT-Col precoating. Collectively, these data indicate that AT-Col/BCP may be potentially used as a bone substitute to enable effective bone regeneration through enhanced new blood vessel formation and osteoclast activation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1446-1456, 2017.

Comparative study of the effect of PTH (1-84) and strontium ranelate in an experimental model of atrophic nonunion

This study aimed to set up an experimental model of long bone atrophic nonunion and to explore the potential role of PTH-1-84 (PTH 1-84) and strontium ranelate (SrR). A model of atrophic nonunion was created in Sprague-Dawley rats at the femoral midshaft level. The animals were randomised into four groups. Group A1: control rodents, fracture without bone gap; Group A2: rodents with subtraction osteotomy (non-union model control) treated with saline; Group B: rodents with subtraction osteotomy treated with human-PTH (PTH 1-84); and Group C: rodents with subtraction osteotomy treated with strontium ranelate (SrR). The groups were followed for 12 weeks. X-rays were be obtained at weeks 1, 6 and 12. After sacrificing the animals, we proceeded to the biomechanical study and four point bending tests to evaluate the resistance of the callus and histological study. In second phase, the expression of genes related to osteoblast function was analysed by reverse transcription-quantitative PCR in rats subjected to substraction osteotomy and treated for 2 weeks. The animals were randomised into three groups: Group A2: rodents treated with saline; Group B: rodents treated with PTH 1-84 and Group C: rodents treated with SrR.

RESULTS

No significant histological differences were found between animals subjected to subtraction osteotomy and treated with either saline or PTH (p=0.628), but significant difference existed between animals receiving saline or SrR (p=0.005). There were no significant differences in X-ray score between the saline and PTH groups at either 6 or 12 weeks (p=0.33 and 0.36, respectively). On the other hand, better X-ray scores were found in the SrR group (p=0.047 and 0.006 in comparison with saline, at 6 and 12 weeks, respectively). In line with this, biomechanical tests revealed improved results in the SrR group. Gene expression analysis revealed a slightly decreased levels of DKK1, a Wnt pathway inhibitor, in rats treated with SrR.

CONCLUSIONS

SrR increases has a beneficial effect in this atrophic non-union model in rats. This suggests that it might have a role may have important implications for the potential clinical role in the treatment of fracture nonunion.

A new, low cost, locking plate for the long-term fixation of a critical size bone defect in the ratfemur: in vivo performance, biomechanical and finite element analysis

BACKGROUND

The optimum fixation device for the critical size bone defect is not established yet.

OBJECTIVE

A reliable, feasible and low-cost fixation device for the long-term maintenance of a critical bone defect.

METHODS

A custom-made plate made of poly-methyl-methacrylate was used for the fixation of a critical defect of rats' femurs. The screws were securely fixing both on the plate and the bone. A three point bending test, aimed to resemble the in vivo loading pattern, a Finite Element Analysis and a 24-week in vivo monitoring of the integrity of the plate fixation were utilized.

RESULTS

The plate has linear and reproducible behavior. It presents no discontinuities in the stress field of the fixation. Its properties are attributed to the material and the locking principle. It fails beyond the level of magnitude of the normal ambulatory loads. In vivo, 100% of the plates maintained the bone defect intact up to 12 weeks and 85% of them at 24 weeks.

CONCLUSION

This novel locking plate shows optimal biomechanical performance and reliability with high long-term in vivo survival rate. It is fully implantable, inexpensive and easily manufactured. It can be qualified for long term critical defect fixation in bone regeneration studies.

Enhanced bone healing by improved fibrin-clot formation via fibrinogen adsorption on biphasic calcium phosphate granules

OBJECTIVES

Fibrin clots play an important role in bone tissue regeneration. This study aimed at improving the fibrin-clotting rate by coating the surface of biphasic calcium phosphate (BCP) granules with fibrinogen (FNG).

METHODS AND MATERIALS

FNG was coated on the BCP surface using an adsorption and freeze-drying method. The surface morphology of FNG-adsorbed BCP (FNG-BCP) was characterized using scanning electron microscopy (SEM), and the stability of the adsorbed FNG evaluated by gel electrophoresis and circular dichroism (CD) analysis. The biocompatibility of FNG-BCP was evaluated in vitro using human mesenchymal stem cells, and in vivo bone-healing efficiency determined using a rabbit calvarial bone defect model.

RESULTS

SEM studies showed numerous irregularly distributed FNG fractions adsorbed onto the surface of BCP granules. Gel electrophoresis, CD analysis, and in vitro coagulation results showed that the adsorbed FGN maintained its native protein structure and clotting properties. Biocompatibility experiments showed that cell proliferation and adhesion were improved in cells cultivated on the FNG-BCP granules. After surgical implantation into the bone defects, the FNG-BCP granules coagulated at the defect site by reacting with the blood discharged from the surgical site tissue. In addition, at 8 weeks, the volume of FNG40-BCP (P = 0.012) was significantly higher than that of BCP alone in the newly formed bone.

CONCLUSIONS

These results indicate that self-coagulating FNG-CBP granules may have the potential to be used as a bone substitute for enabling effective bone repair through rapid fibrin-clot formation.

Miniature pigs as an animal model for implant research: bone regeneration in critical-size defects

OBJECTIVE

Standardized experimental investigations determining the critical-size defect (CSD) in the mandible of miniature pigs are still lacking. The aim of the present study was to obtain information about the new bone formation in created defects of varying sizes.

STUDY DESIGN

Marginal resection of the alveolar crest of the lower jaw was performed in 3 female miniature pigs. The animals used in the study were 3 years of age and weighed approximately 55 kg. For histologic evaluation the dental implants were harvested with the surrounding bone tissue 10 weeks after implant placement. For this, bone segments including the implants were removed from each side of the mandible. The sizes of the resected bone blocks varied, showing the following volumes: 10.1 cm(3), 4.2 cm(3), and 1.9 cm(3). Periosteal coverage of the defects was performed. Computerized tomography (CT) of the skull of the miniature pig was performed immediately after the surgical procedure as well as 6 weeks later using a 64-channel mult-slice scanner.

RESULTS

The CT showed that 6 weeks after obtaining the biopsies, the filling of the defects with new bone varied. The percentage of newly formed bone in relation to the size of the original defect was 57.4% for the small- and 87.2% for the middle-sized defect. The large-sized defect showed 75.5% newly formed bone compared with baseline.

CONCLUSION

Considering the amount of new bone formation found within this study, it is questionable if the critical defect size of 5 cm(3) stated in the literature is valid. Further research concerning the mandibular model in minipigs is required and more refinement needed to assure a standardized CSD, allowing qualitative and quantitative evaluation of bone grafts and bone graft substitutes.

Bone healing and migration of cord blood-derived stem cells into a critical size femoral defect after xenotransplantation

Stem cell and tissue engineering-based therapies have become a promising option to heal bony defects in the future. Human cord blood-derived mesenchymal stem cells were seeded onto a collagen/tricalcium phosphate scaffold and xenotransplanted into critical size femoral defects of 46 nude rats. We found a survival of human cells within the scaffold and surrounding bone/bone marrow up to 4 wk after transplantation and an increased bone healing rate compared with controls without stem cells. This study supports the application of cord blood stem cells for bone regeneration.

INTRODUCTION

The treatment of critical size bone defects is still a challenging problem in orthopedics. In this study, the survival, migration, and bone healing promoting potency of cord blood-derived stem cells were elucidated after xenotransplantation into a critical size femoral defect in athymic nude rats.

MATERIALS AND METHODS

Unrestricted somatic stem cells (USSCs) isolated from human cord blood were tested toward their mesenchymal in vitro potency and cultivated onto a collagen I/III and beta-tricalcium phosphate (beta-TCP) scaffold. The biomaterial-USSC composite was transplanted into a 4-mm femoral defect of 40 nude rats and stabilized by an external fixator. Twelve animals without USSCs served as controls. Cell survival, migration, and bone formation were evaluated by blood samples, X-rays, and histological and immunocytochemical analysis of different organs within a maximal postoperative follow-up of 10 wk.

RESULTS

Of the 52 nude rats, 46 animals were evaluated (drop-out rate: 11.5%). Human-derived stem cells showed an engraftment within the scaffold and adjacent femur up to 4 wk after xenotransplantation. With further time, the human cells were destroyed by the host organism. We found a significant increase in bone formation in the study group compared with controls. USSC transplantation did not significantly influence blood count or body weight in athymic nude rats. Whereas the collagen I/III scaffold was almost resorbed 10 wk after transplantation, there were still significant amounts of TCP present in transplantation sites at this time.

CONCLUSIONS

Human cord blood-derived stem cells showed significant engraftment in bone marrow, survived within a collagen-TCP scaffold up to 4 wk, and increased local bone formation in a nude rat's femoral defect.

The critical size bony defect in a small animal for bone healing studies (II): implant evolution and surgical technique on a rat's femur

In the preclinical field of orthopaedic and trauma surgery critical size bony defects (CDS) were used to evaluate the biocompatibility and allow to investigate the osteoinductivity and -conductivity of bone substitutes. Concerning the anatomical size the laboratory rat indicates a lower limit in small animals which are appropriate for experiments on bone. The aim of this study was to define a CSD, to develop a suitable fixation system to stabilize bony fragments in CSD and to point out the specialities of the surgical technique. These informations should help for to design and practice studies concerning bone healing on rat's femur. Based on previously acquired anatomical data of rat's femur, the technical challenges and anatomical specialities of different osteosynthesis techniques in rat's femur surgery are demonstrated. Our experiences with different fixation systems and techniques lead to the development of an external fixator, which guarantees for a stable bone fragment fixation, prevents severe soft tissue damage, allows of a roentgenologic evaluation of the defect zone and prevents from undesired direct biomaterial-implant interactions. Neither the proximal nor the distal femoral nailing technique is appropriate for a stable fixation in CSD of rat's femur. To evaluate the reliability of an own developed external fixator 42 nude rats with a 4.0 mm CSD were investigated clinically and roentgenologically over 10 weeks. The external fixator showed only a small implant failure rate. A solid fusion of the bone fragments was not observed within the 10 weeks follow-up period.