Osteopromotion by a beta-tricalcium phosphate/bone marrow hybrid implant for use in spine surgery.
METHODS
Experimental animal study. OBJECTIVE.: Evaluate osteopromotive properties of a beta-tricalcium phosphate (TCP) implant with different osteogenic substances in an animal study.


BACKGROUND
Current research in spine surgery is focusing on resorbable bone implants because of the high morbidity after iliac crest graft harvesting. Therefore, several osteoconductive scaffolds are combined with osteoinductive substances.


METHODS
In 14 sheep, a critical size defect was performed on both tibiae. The sheep were randomized into 3 groups (4 sheep each) and a control group (2 sheep). In the treatment groups, the defects were filled with the beta-TCP scaffold impregnated with either venous blood, bone marrow from sternal aspiration, or a concentrated mononuclear cell suspension derived from sternal bone marrow aspiration. The sheep in each group were euthanized 6 and 12 weeks after the operation; the investigation included quantitative computerized tomography and histology.


RESULTS
The best bone formation occurred in the bone marrow group after 6 and 12 weeks, whereas no difference was found between the cell and venous blood groups. Only the bone marrow group showed bone formation inside the scaffold after 6 weeks. We conclude that a beta-TCP scaffold filled with bone marrow aspiration creates a biologic resorbable bone substitute with high osteopromoting capacity. Surprisingly, no better bone formation occurred in the concentrated cells group, which may be a result of technical reasons and needs to be further evaluated.


CONCLUSIONS
The combination of beta-TCP and bone marrow has superior osteopromotive properties to venous blood or concentrated mononuclear cells and can be used effectively as a substitute to iliac crest graft.
Becker
Stephan
S
Spine Centre, Orthopedic Hospital Speising, Vienna, Austria. stephan.becker@oss.at
Maissen
Otto
O
Ponomarev
Igor
I
Igor
Ponomarev
P
Stoll
Thierry
T
Thierry
Stoll
S
Rahn
Berton
B
Wilke
Ingo
I
Ingo
Wilke
W
D000818:Animals; D001672:Biocompatible Materials / Q000494:pharmacology*; D001854:Bone Marrow Cells / Q000166:cytology; D016026:Bone Marrow Transplantation; D018786:Bone Substitutes; D002130:Calcium Phosphates / Q000494:pharmacology*; D002516:Ceramics / Q000494:pharmacology*; D016268:Internal Fixators; D023421:Models, Animal; D016348:Osseointegration / Q000187:drug effects* / Q000502:physiology; D010865:Pilot Projects; D012756:Sheep; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D013977:Tibia; D014182:Transplantation, Autologous
D001672:Biocompatible Materials; D018786:Bone Substitutes; D002130:Calcium Phosphates; C485817:beta-tricalcium phosphate