title: Effectiveness of bone marrow transplantation for revitalizing a severely necrotic small bone: experimental rabbit model.
abstract: BACKGROUND
  Although treating Kienböck disease is controversial, we previously applied a new method that was less invasive and comprised drilling, bone marrow (BM) transplantation, external fixation, and radiating low-intensity pulsed ultrasound. We reported good clinical results obtained by this new method, which were comparable to those obtained using other, rather invasive methods. Here, we investigated the effect of drilling holes and transplanting BM into necrotic bone in an animal model to further understand the effect of these methods on the revitalization of necrotic bone.
  
  
  METHODS
  We used rabbit fourth tarsal bones, whose surfaces consist of cartilage and cortical bone, mimicking human lunate bone. We soaked the retrieved bones in liquid nitrogen to induce necrosis. After thawing, we inserted them separately into bilateral subcutaneous pouches in the backs of rabbits. A total of 60 rabbits were divided into four groups of 15 rabbits each: BM transplantation (BM group); peripheral blood transplantation (PB group); drilling (D group); control (C group). We sacrificed three rabbits to obtain six specimens in each group at 2, 4, 8, 12, and 20 weeks after operation and evaluated the specimens histomorphologically.
  
  
  RESULTS
  In the BM group, significantly larger mineralizing surfaces, osteoblast surfaces, and osteoclast numbers were observed at 4, 8, and 12 weeks compared with those in the other groups. No significant differences were observed at 2 and 20 weeks in the groups except the mineralizing surface of the 20-week-BM group, which was significantly greater.
  
  
  CONCLUSIONS
  We examined the efficacy of drilling and of BM transplantation for regenerating necrotic bone in a rabbit model. Our experiments suggest that drilling with BM transplantation to the necrotic bone accelerates bone formation and remodeling.
authors.affiliation: Department of Orthopaedic Surgery, Kikkoman General Hospital, Noda, Chiba, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogawa
authors.forename: Tomoo
authors.initials: T
authors.lastname: Ishii
authors.forename: Hajime
authors.initials: H
authors.lastname: Mishima
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Sakai
authors.forename: Arata
authors.initials: A
authors.lastname: Watanabe
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Nishino
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Ochiai
mesh_terms: D000818:Animals; D054544:Arthroplasty, Subchondral; D016026:Bone Marrow Transplantation; D001861:Bone Regeneration / Q000502:physiology; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D005260:Female; D010025:Osteoradionecrosis / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011817:Rabbits