AUTOCLAVED AUTOGRAFT BONE COMBINED WITH VASCULARIZED BONE AND BONE-MARROW

Citation
Y. Taguchi et al., AUTOCLAVED AUTOGRAFT BONE COMBINED WITH VASCULARIZED BONE AND BONE-MARROW, Clinical orthopaedics and related research, (320), 1995, pp. 220-230
Citations number
40
Categorie Soggetti
Surgery,Orthopedics
ISSN journal
0009921X
Issue
320
Year of publication
1995
Pages
220 - 230
Database
ISI
SICI code
0009-921X(1995):320<220:AABCWV>2.0.ZU;2-P
Abstract
In this study, the authors investigated enhancing the results of autoc laved autograft bone by combining it with a vascularized bone graft an d supplementing it with autogenous bone marrow for replacement of a 2- cm tibial defect in the rabbit model. The study was divided into 4 gro ups. Group I consisted of autoclaved autograft bone only; Group II, au toclaved autograft bone and vascularized bone graft; Group III, autocl aved autograft bone and autogenous bone marrow; and Group IV, autoclav ed bone and autogenous bone marrow and vascularized bone graft. The va scularized bone graft was provided by the ipsilateral fibula, pedicled on the peroneal vessels, and transposed to sit alongside the autoclav ed bone. In Group I, all grafts had nonunion at 16 weeks. In Group II, new bone formation was seen at the proximal and distal site of the au toclaved bone, host bone, and vascularized fibular graft junction as e arly as 2 weeks, and bony union occurred at the 16th week. The autogen ous bone marrow-supplemented groups (III and IV) had new bone formatio n along the entire length of the autoclaved bone. Bony union at the pr oximal and distal junction was seen as early as 4 weeks, extending to the entire autoclaved bone by the eigth week (98% of the cases with 1 case of infection). Histologic examination showed revascularization an d capillary ingrowth into the autoclaved bone at 16 weeks, with a sign ificantly improved torsional stiffness when compared with the groups w ithout autogenous bone marrow supplementation. The addition of vascula rized bone graft resulted in an improved union rate as compared with t he autoclaved bone alone. Autogenous bone marrow supplementation, in a ddition to the vascularized bone graft, resulted in rapid new bone for mation all around the autoclaved bone, early revascularization and inc orporation of the autoclaved bone, and a significantly improved torsio nal stiffness of the reconstruction.