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Boller LA, McGough MA, Shiels SM, Duvall CL, Wenke JC, Guelcher SA. Settable Polymeric Autograft Extenders in a Rabbit Radius Model of Bone Formation. Materials (Basel) 2021; 14:ma14143960. [PMID: 34300888 PMCID: PMC8305944 DOI: 10.3390/ma14143960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
Autograft (AG) is the gold standard for bone grafts, but limited quantities and patient morbidity are associated with its use. AG extenders have been proposed to minimize the volume of AG while maintaining the osteoinductive properties of the implant. In this study, poly(ester urethane) (PEUR) and poly(thioketal urethane) (PTKUR) AG extenders were implanted in a 20-mm rabbit radius defect model to evaluate new bone formation and graft remodeling. Outcomes including µCT and histomorphometry were measured at 12 weeks and compared to an AG (no polymer) control. AG control examples exhibited new bone formation, but inconsistent healing was observed. The implanted AG control was resorbed by 12 weeks, while AG extenders maintained implanted AG throughout the study. Bone growth from the defect interfaces was observed in both AG extenders, but residual polymer inhibited cellular infiltration and subsequent bone formation within the center of the implant. PEUR-AG extenders degraded more rapidly than PTKUR-AG extenders. These observations demonstrated that AG extenders supported new bone formation and that polymer composition did not have an effect on overall bone formation. Furthermore, the results indicated that early cellular infiltration is necessary for harnessing the osteoinductive capabilities of AG.
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Affiliation(s)
- Lauren A. Boller
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA; (L.A.B.); (M.A.P.M.); (C.L.D.)
| | - Madison A.P. McGough
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA; (L.A.B.); (M.A.P.M.); (C.L.D.)
| | - Stefanie M. Shiels
- U.S. Army Institute of Surgical Research, 3698 Chambers Rd, San Antonio, TX 78234, USA; (S.M.S.); (J.C.W.)
| | - Craig L. Duvall
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA; (L.A.B.); (M.A.P.M.); (C.L.D.)
| | - Joseph C. Wenke
- U.S. Army Institute of Surgical Research, 3698 Chambers Rd, San Antonio, TX 78234, USA; (S.M.S.); (J.C.W.)
| | - Scott A. Guelcher
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA; (L.A.B.); (M.A.P.M.); (C.L.D.)
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235, USA
- Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, 1211 Medical Center Dr., Nashville, TN 37212, USA
- Correspondence:
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McGough MA, Boller LA, Groff DM, Schoenecker JG, Nyman JS, Wenke JC, Rhodes C, Shimko D, Duvall CL, Guelcher SA. Nanocrystalline hydroxyapatite-poly(thioketal urethane) nanocomposites stimulate a combined intramembranous and endochondral ossification response in rabbits. ACS Biomater Sci Eng 2020; 6:564-574. [PMID: 32405537 PMCID: PMC7220073 DOI: 10.1021/acsbiomaterials.9b01378] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Resorbable bone cements are replaced by bone osteoclastic resorption and osteoblastic new bone formation near the periphery. However, the ideal bone cement would be replaced by new bone through processes similar to fracture repair, which occurs through a variable combination of endochondral and intramembranous ossification. In this study, nanocrystalline hydroxyapatite (nHA)-poly(thioketal urethane) (PTKUR) cements were implanted in femoral defects in New Zealand White rabbits to evaluate ossification at 4, 12, and 18 months. Four formulations were tested: an injectable, flowable cement and three moldable putties with varying ratios of calcium phosphate to sucrose granules. New bone formation and resorption of the cement by osteoclasts occurred near the periphery. Stevenel's Blue and Safranin O staining revealed infiltration of chondrocytes into the cements and ossification of the cartilaginous intermediate. These findings suggest that nHA-PTKUR cements support combined intramembranous and endochondral ossification, resulting in enhanced osseointegration of the cement that could potentially improve patient outcomes.
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Affiliation(s)
- Madison A.P. McGough
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
| | - Lauren A. Boller
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
| | - Dustin M. Groff
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
| | - Jonathan G. Schoenecker
- Vanderbilt Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
- Department of Orthopaedics, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
| | - Jeffry S. Nyman
- Vanderbilt Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
- Department of Orthopaedics, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
| | - Joseph C. Wenke
- U.S. Army Institute of Surgical Research, 3698 Chambers Rd, San Antonio, TX 78234
| | - Cheyenne Rhodes
- Medtronic Spinal & Biologics, 1800 Pyramid Pl, Memphis, TN 38132
| | - Dan Shimko
- Medtronic Spinal & Biologics, 1800 Pyramid Pl, Memphis, TN 38132
| | - Craig L. Duvall
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
| | - Scott A. Guelcher
- Department of Biomedical Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, 2201 West End Ave, Nashville, TN 37235
- Vanderbilt Center for Bone Biology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37212
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