BACKGROUND: There is a clinical need for bone replacement strategies because of the shortfalls endemic to autologous bone grafting, especially in the pediatric patient population. For the past 25 years, the animal model that has been used to test bone replacement strategies has been the calvarial critical-size defect, based on the initial size of the bone defect. This study was undertaken to test the concept of the critical size in several different models. A review of the theoretical and scientific bases for the critical-size defect was also undertaken. METHODS: Two different rodent species (including 28 adult mice and six adult rats) were used to assess bone healing by means of two-dimensional radiographic analysis after creating small bone defects using different surgical techniques. RESULTS: Defects in mice that were smaller than critical-size defects (1.8-mm diameter) were shown to heal a maximum of 50 percent 1 year postoperatively. Small defects (2.3-mm diameter) in the rat skull showed approximately 35 percent healing after 6 weeks. Neither the choice of rodent species nor the maintenance of the dura mater significantly affected calvarial bone healing. CONCLUSIONS: These results suggest that calvarial bone healing is not well described and much more data need to be collected. Also, after a review of the existing literature and a critique of the clinical applicability of the model, it is suggested that the use of the term "critical-size defect" be discontinued.
BACKGROUND: There is a clinical need for bone replacement strategies because of the shortfalls endemic to autologous bone grafting, especially in the pediatric patient population. For the past 25 years, the animal model that has been used to test bone replacement strategies has been the calvarial critical-size defect, based on the initial size of the bone defect. This study was undertaken to test the concept of the critical size in several different models. A review of the theoretical and scientific bases for the critical-size defect was also undertaken. METHODS: Two different rodent species (including 28 adult mice and six adult rats) were used to assess bone healing by means of two-dimensional radiographic analysis after creating small bone defects using different surgical techniques. RESULTS: Defects in mice that were smaller than critical-size defects (1.8-mm diameter) were shown to heal a maximum of 50 percent 1 year postoperatively. Small defects (2.3-mm diameter) in the rat skull showed approximately 35 percent healing after 6 weeks. Neither the choice of rodent species nor the maintenance of the dura mater significantly affected calvarial bone healing. CONCLUSIONS: These results suggest that calvarial bone healing is not well described and much more data need to be collected. Also, after a review of the existing literature and a critique of the clinical applicability of the model, it is suggested that the use of the term "critical-size defect" be discontinued.
Authors: Jason A Spector; Joshua A Greenwald; Stephen M Warren; Pierre J Bouletreau; Francesca E Crisera; Babak J Mehrara; Michael T Longaker Journal: Plast Reconstr Surg Date: 2002-02 Impact factor: 4.730
Authors: J A Greenwald; B J Mehrara; J A Spector; P J Fagenholz; P B Saadeh; D S Steinbrech; G K Gittes; M T Longaker Journal: Plast Reconstr Surg Date: 2000-09 Impact factor: 4.730
Authors: Jason A Spector; Joshua A Greenwald; Stephen M Warren; Pierre J Bouletreau; Robert C Detch; Peter J Fagenholz; Francesca E Crisera; Michael T Longaker Journal: Plast Reconstr Surg Date: 2002-02 Impact factor: 4.730
Authors: J Y Lee; D Musgrave; D Pelinkovic; K Fukushima; J Cummins; A Usas; P Robbins; F H Fu; J Huard Journal: J Bone Joint Surg Am Date: 2001-07 Impact factor: 5.284
Authors: Catherine M Cowan; Yun-Ying Shi; Oliver O Aalami; Yu-Fen Chou; Carina Mari; Romy Thomas; Natalina Quarto; Christopher H Contag; Benjamin Wu; Michael T Longaker Journal: Nat Biotechnol Date: 2004-04-11 Impact factor: 54.908
Authors: Oliver O Aalami; Randall P Nacamuli; Kelly A Lenton; Catherine M Cowan; Tony D Fang; Kenton D Fong; Yun-Ying Shi; HanJoon M Song; David E Sahar; Michael T Longaker Journal: Plast Reconstr Surg Date: 2004-09-01 Impact factor: 4.730
Authors: Antonios G Mikos; Susan W Herring; Pannee Ochareon; Jennifer Elisseeff; Helen H Lu; Rita Kandel; Frederick J Schoen; Mehmet Toner; David Mooney; Anthony Atala; Mark E Van Dyke; David Kaplan; Gordana Vunjak-Novakovic Journal: Tissue Eng Date: 2006-12
Authors: Arun K Gosain; Timothy D Santoro; Lian-Sheng Song; Christopher C Capel; P V Sudhakar; Hani S Matloub Journal: Plast Reconstr Surg Date: 2003-08 Impact factor: 4.730
Authors: Zachary J Grey; R Nicole Howie; Emily L Durham; Sarah Rose Hall; Kristi L Helke; Martin B Steed; Amanda C LaRue; Robin C Muise-Helmericks; James J Cray Journal: Wound Repair Regen Date: 2019-03-09 Impact factor: 3.617
Authors: Michael E Frohbergh; Anya Katsman; Mark J Mondrinos; Collin T Stabler; Kurt D Hankenson; Jeffrey T Oristaglio; Peter I Lelkes Journal: Tissue Eng Part A Date: 2014-12-16 Impact factor: 3.845
Authors: Nikita Tripuraneni; Marissa K Srour; John W Funnell; Thu Zan Tun Thein; Francesca V Mariani Journal: J Vis Exp Date: 2015-01-21 Impact factor: 1.355
Authors: Sarita R Shah; Simon Young; Julia L Goldman; John A Jansen; Mark E Wong; Antonios G Mikos Journal: Nat Protoc Date: 2016-09-22 Impact factor: 13.491
Authors: Vijay R Ramakrishnan; Adam M Terella; Seerat Poonia; Alexander G Chiu; James N Palmer Journal: J Craniofac Surg Date: 2017-01 Impact factor: 1.046
Authors: Rebekah M Samsonraj; Amel Dudakovic; Pengfei Zan; Oksana Pichurin; Simon M Cool; Andre J van Wijnen Journal: Tissue Eng Part C Methods Date: 2017-07-03 Impact factor: 3.056
Authors: Gábor Skaliczki; Károly Schandl; Miklós Weszl; Tibor Major; Miklós Kovács; József Skaliczki; Miklós Szendrői; Csaba Dobó-Nagy; Zsombor Lacza Journal: Int Orthop Date: 2013-01-15 Impact factor: 3.075