title: Mechanical induction of critically delayed bone healing in sheep: radiological and biomechanical results.
abstract: This study aimed to mechanically produce a standardized ovine model for a critically delayed bone union. A tibial osteotomy was stabilized with either a rigid (group I) or mechanically critical (group II) external fixator in sheep. Interfragmentary movements and ground reaction forces were monitored throughout the healing period of 9 weeks. After sacrifice at 6 weeks, 9 weeks and 6 months, radiographs were taken and the tibiae were examined mechanically. Interfragmentary movements were considerably larger in group II throughout the healing period. Unlike group I, the operated limb in group II did not return to full weight bearing during the treatment period. Radiographic and mechanical observations showed significantly inferior bone healing in group II at 6 and 9 weeks compared to group I. After 6 months, five sheep treated with the critical fixator showed radiological bridging of the osteotomy, but the biomechanical strength of the repair was still inferior to group I at 9 weeks. The remaining three animals had even developed a hypertrophic non-union. In this study, mechanical instability was employed to induce a critically delayed healing model in sheep. In some cases, this approach even led to the development of a hypertrophic non-union. The mechanical induction of critical bone healing using an external fixation device is a reasonable attempt to investigate the patho-physiological healing cascade without suffering from any biological intervention. Therefore, the presented ovine model provides the basis for a comparative evaluation of mechanisms controlling delayed and standard bone healing.
authors.affiliation: Center for Musculoskeletal Surgery, Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Schell
authors.forename: Mark S
authors.initials: MS
authors.lastname: Thompson
authors.forename: Hermann J
authors.initials: HJ
authors.lastname: Bail
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Hoffmann
authors.forename: Alexander
authors.initials: A
authors.lastname: Schill
authors.forename: Georg N
authors.initials: GN
authors.lastname: Duda
authors.forename: Jasmin
authors.initials: J
authors.lastname: Lienau
mesh_terms: D000818:Animals; D019245:Compressive Strength; D003198:Computer Simulation; D005260:Female; D005592:Fracture Fixation; D017102:Fracture Healing / Q000502:physiology*; D017759:Fractures, Malunited / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D008954:Models, Biological; D010812:Physical Stimulation / Q000379:methods; D011859:Radiography; D012756:Sheep; D013977:Tibia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D016474:Weight-Bearing