AUTOCLAVED BONE FOR CRANIOFACIAL RECONSTRUCTION - EFFECTS OF SUPPLEMENTATION WITH BONE-MARROW OR RECOMBINANT HUMAN FIBROBLAST GROWTH FACTOR-2

Replantation of resected bone after autoclaving is employed by many un its in both craniofacial and orthopedic tumor reconstructive surgery. The procedure is attractive because it maintains the original anatomy, is reliable, and provides a good immediate clinical result. However, doubts have been raised about the ability of the autoclaved bone to re vitalize. The present study aimed to explore, in an animal model, the revitalization of autoclaved bone and to determine whether it would be possible to enhance graft revitalization using tither autogeneic bone marrow or recombinant human fibroblast growth factor-2, a peptide wit h stimulatory effects on both endothelial and osteogenic cells. Twenty -eight adult rats were subjected to bilateral parietal cranioplasties (4 x 6 mm), and 75 per cent of the grafts were subjected to autoclavin g (121 degrees C; 20 minutes) and subsequently treated randomly accord ing to one of the following strategies: no further treatment, or suppl ementation with bone marrow or recombinant human fibroblast growth fac tor-2. The remaining grafts were replanted as fresh autografts. The re sults were evaluated after 4 and 12 weeks by radiologic, histologic, a nd histomorphometric analyses. After 4 weeks, no major differences wer e observed between treatments. At 12 weeks, however, no distinction in graft revitalization between autografts and autoclaved grafts supplem ented with recombinant human fibroblast growth factor-2 was observed, whereas autoclaved grafts with or without bone marrow displayed signif icantly less revitalization compared with autografts. The results indi cate that autoclaved bone will revitalize by remodeling, and that the efficacy of this process can he increased significantly by simultaneou s supplementation with recombinant human fibroblast growth factor-2.