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2015 ; 7
(3
): 383-91
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Demineralized Bone Matrix Injection in Consolidation Phase Enhances Bone
Regeneration in Distraction Osteogenesis via Endochondral Bone Formation
#MMPMID26330963
Kim JB
; Lee DY
; Seo SG
; Kim EJ
; Kim JH
; Yoo WJ
; Cho TJ
; Choi IH
Clin Orthop Surg
2015[Sep]; 7
(3
): 383-91
PMID26330963
show ga
BACKGROUND: Distraction osteogenesis (DO) is a promising tool for bone and tissue
regeneration. However, prolonged healing time remains a major problem. Various
materials including cells, cytokines, and growth factors have been used in an
attempt to enhance bone formation. We examined the effect of percutaneous
injection of demineralized bone matrix (DBM) during the consolidation phase on
bone regeneration after distraction. METHODS: The immature rabbit tibial DO model
(20 mm length-gain) was used. Twenty-eight animals received DBM 100 mg
percutaneously at the end of distraction. Another 22 animals were left without
further procedure (control). Plain radiographs were taken every week. Postmortem
bone dual-energy X-ray absorptiometry and micro-computed tomography (micro-CT)
studies were performed at the third and sixth weeks of the consolidation period
and histological analysis was performed. RESULTS: The regenerate bone mineral
density was higher in the DBM group when compared with that in the saline
injection control group at the third week postdistraction. Quantitative analysis
using micro-CT revealed larger trabecular bone volume, higher trabecular number,
and less trabecular separation in the DBM group than in the saline injection
control group. Cross-sectional area and cortical thickness at the sixth week
postdistraction, assessed using micro-CT, were greater in the regenerates of the
DBM group compared with the control group. Histological evaluation revealed
higher trabecular bone volume and trabecular number in the regenerate of the DBM
group. New bone formation was apparently enhanced, via endochondral ossification,
at the site and in the vicinity of the injected DBM. DBM was absorbed slowly, but
it remained until the sixth postoperative week after injection. CONCLUSIONS: DBM
administration into the distraction gap at the end of the distraction period
resulted in a significantly greater regenerate bone area, trabecular number, and
cortical thickness in the rabbit tibial DO model. These data suggest that
percutaneous DBM administration at the end of the distraction period or in the
early consolidation period may stimulate regenerate bone formation and
consolidation in a clinical situation with delayed bone healing during DO.