Christoph Nau1, Dirk Henrich1, Caroline Seebach1, Katrin Schröder2, Sammy-Jo Fitzsimmons3, Svenja Hankel1, John H Barker3, Ingo Marzi1, Johannes Frank1. 1. 1 Department of Trauma, Hand and Reconstructive Surgery, Johann Wolfgang Goethe-University , Frankfurt/Main, Germany . 2. 2 Institut für Kardiovaskuläre Physiologie, Fachbereich Medizin der Goethe-Universität , Frankfurt am Main, Germany . 3. 3 Frankfurt Initiative for Regenerative Medicine, Johann Wolfgang Goethe-University , Frankfurt/Main, Germany .
Abstract
INTRODUCTION: The surgical treatment of large bone defects continues to pose a major challenge in modern trauma and orthopedic surgery. In this study we test the effectiveness of a tissue engineering approach, using three-dimensional (3D) β-tricalcium phosphate (β-TCP) scaffolding plus bone marrow-derived mononuclear cells (BM-MNCs), combined with a vascularized periosteal flap, in a rat femur critical size defect model. METHODS: Eighty rats were randomly allocated into four equal groups. Under general anesthesia, critical size defects were created on their femurs and were treated with (1) Vascularized periosteal flap alone, (2) Vascularized periosteal flap+β-TCP scaffolding, (3) Vascularized periosteal flap+β-TCP scaffolding+ligated vascular pedicle, and (4) Vascularized periosteal flap+β-TCP scaffolding+BM-MNCs. After 4 and 8 weeks animals were euthanized and the bone defects were harvested for analysis of new bone formation, vascularization, and strength using histology, immunohistology, micro-CT, and biomechanical testing, respectively. RESULTS: Group 1: (P. flap) Increase in new bone formation and vascularization. Group 2: (P. flap+scaffold) Increase in new bone formation and vascularization. Group 3: (P. flap+scaffold+ligated vascular pedicle) No new bone formation and no vascularization. Group 4: (P. flap+scaffold+BM-MNCs) A significant (p < 0.05) increase was seen in new bone formation, vascularization, and strength in bones treated with flaps, scaffold, and BM-MNCs, when compared with the other treatment groups. CONCLUSION: Combining a vascularized periosteal flap with tissue engineering approach (β-TCP scaffolding and BM-MNC) results in significantly improved bone healing in our rat femur critical size bone defect model.
INTRODUCTION: The surgical treatment of large bone defects continues to pose a major challenge in modern trauma and orthopedic surgery. In this study we test the effectiveness of a tissue engineering approach, using three-dimensional (3D) β-tricalcium phosphate (β-TCP) scaffolding plus bone marrow-derived mononuclear cells (BM-MNCs), combined with a vascularized periosteal flap, in a rat femur critical size defect model. METHODS: Eighty rats were randomly allocated into four equal groups. Under general anesthesia, critical size defects were created on their femurs and were treated with (1) Vascularized periosteal flap alone, (2) Vascularized periosteal flap+β-TCP scaffolding, (3) Vascularized periosteal flap+β-TCP scaffolding+ligated vascular pedicle, and (4) Vascularized periosteal flap+β-TCP scaffolding+BM-MNCs. After 4 and 8 weeks animals were euthanized and the bone defects were harvested for analysis of new bone formation, vascularization, and strength using histology, immunohistology, micro-CT, and biomechanical testing, respectively. RESULTS: Group 1: (P. flap) Increase in new bone formation and vascularization. Group 2: (P. flap+scaffold) Increase in new bone formation and vascularization. Group 3: (P. flap+scaffold+ligated vascular pedicle) No new bone formation and no vascularization. Group 4: (P. flap+scaffold+BM-MNCs) A significant (p < 0.05) increase was seen in new bone formation, vascularization, and strength in bones treated with flaps, scaffold, and BM-MNCs, when compared with the other treatment groups. CONCLUSION: Combining a vascularized periosteal flap with tissue engineering approach (β-TCP scaffolding and BM-MNC) results in significantly improved bone healing in our rat femur critical size bone defect model.
Authors: Anja Klein; Andreas Baranowski; Ulrike Ritz; Christiane Mack; Hermann Götz; Eva Langendorf; Bilal Al-Nawas; Philipp Drees; Pol M Rommens; Alexander Hofmann Journal: Eur J Trauma Emerg Surg Date: 2019-05-28 Impact factor: 3.693
Authors: Irene Gallardo-Calero; Sergi Barrera-Ochoa; Maria Cristina Manzanares; Andrea Sallent; Matias Vicente; Alba López-Fernández; Matias De Albert; Marius Aguirre; Francisco Soldado; Roberto Vélez Journal: Clin Orthop Relat Res Date: 2019-04 Impact factor: 4.176
Authors: Christoph Nau; Dirk Henrich; Caroline Seebach; Katrin Schröder; John H Barker; Ingo Marzi; Johannes Frank Journal: Int J Mol Med Date: 2017-02-21 Impact factor: 4.101
Authors: Liudmila Leppik; Han Zhihua; Sahba Mobini; Vishnu Thottakkattumana Parameswaran; Maria Eischen-Loges; Andrei Slavici; Judith Helbing; Lukas Pindur; Karla M C Oliveira; Mit B Bhavsar; Lukasz Hudak; Dirk Henrich; John H Barker Journal: Sci Rep Date: 2018-04-20 Impact factor: 4.379