Restoration of bone defect and enhancement of bone ingrowth using partially demineralized bone matrix and marrow stromal cells.
OBJECTIVE
This study aimed to investigate the capability of combining marrow stromal cells (MSC) and partially demineralized bone matrix (PDBM) to fill bone defect and enhance bone ingrowth using a canine non-weight-bearing gap model.


METHODS
Custom-made implants with 3mm gap between the porous surface and the host bone were used. The implants were inserted into the distal femurs of 25 mongrel dogs and the gaps were randomly assigned to be filled with culture-expanded autologous MSC-loaded PDBM, autograft, fresh-frozen allograft, PDBM alone, or nothing as controls. Histomorphometry using backscattered scanning electron microscopic examination, and mechanical push-out test were performed at 6 months after surgery.


RESULTS
Histomorphometry showed that amounts of bone regeneration in the gap and bone ingrowth into the porous-coated surface in the MSC-loaded PDBM-treated group were comparable to those of autograft-treated group and were significantly greater than those of allograft-treated, PDBM-treated, or non-grafted groups. Mechanical test showed the same differences.


CONCLUSIONS
The results of this study showed that combining PDBM and autologous culture-expanded MSC restored bone stock and enhanced bone ingrowth into the porous-coated area in a canine non-weight-bearing gap model. This combination may provide an option for reconstructing bone defect when we perform a cementless revision arthroplasty.
Shih
Hsin-Nung
HN
Department of Orthopedic Surgery, Chang-Gung Memorial Hospital, Chang-Gung University, No 5, Fu-Hsing Street, Kwei-Shan, Tao-Yuan 333, Taiwan. lyshih@adm.cgmh.org.tw
Shih
Lih-Yuann
LY
Sung
Tseng-Hwa
TH
Chang
Yuan-Chia
YC
D000818:Animals; D001178:Arthroplasty / Q000379:methods*; D001696:Biomechanical Phenomena; D001846:Bone Development; D001854:Bone Marrow Cells / Q000502:physiology*; D001857:Bone Matrix / Q000502:physiology*; D001861:Bone Regeneration; D016025:Bone Transplantation; D004285:Dogs; D017154:Stromal Cells / Q000502:physiology