title: Role of local insulin augmentation upon allograft incorporation in a rat femoral defect model.
abstract: Each year, over one million orthopedic operations are performed which a bony defect is presence, requiring the use of further augmentation in addition to bony fixation. Application of autogenous bone graft is the standard of care to promote healing of these defects, but several determents exist in using autogenous bone graft exist including limited supply and donor site morbidity. Prior work has demonstrated that local insulin application to fracture sites promote fracture healing, but no work has been performed to date in its effects upon defect healing/allograft incorporation. The goal of this study was to examine the potential role of local insulin application upon allograft incorporation. Microradiographic, histologic, and histomorphometric analysis outcome parameters showed that local insulin significantly accelerated new bone formation. Histological comparisons using predetermined scoring systems demonstrated significantly greater healing in femora treated with insulin compared to control femora (p < 0.001). Quantitatively more bone production was also observed, specifically in areas of endosteal (p = 0.010) and defect (p = 0.041) bone in femora treated with local insulin, compared to control femora, 6 weeks after implantation. This study demonstrates the potential of local insulin as an adjunct for the treatment of segmental defect and allograft incorporation.
authors.affiliation: Department of Orthopaedics, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 185 South Orange Avenue, Newark, New Jersey 07103, USA.
authors.forename: Jemin
authors.initials: J
authors.lastname: Dedania
authors.forename: Robert
authors.initials: R
authors.lastname: Borzio
authors.forename: David
authors.initials: D
authors.lastname: Paglia
authors.forename: Eric A
authors.initials: EA
authors.lastname: Breitbart
authors.forename: Ashley
authors.initials: A
authors.lastname: Mitchell
authors.forename: Swaroopa
authors.initials: S
authors.lastname: Vaidya
authors.forename: Aaron
authors.initials: A
authors.lastname: Wey
authors.forename: Siddhant
authors.initials: S
authors.lastname: Mehta
authors.forename: Joseph
authors.initials: J
authors.lastname: Benevenia
authors.forename: J Patrick
authors.initials: JP
authors.lastname: O'Connor
authors.forename: Sheldon S
authors.initials: SS
authors.lastname: Lin
mesh_terms: D000818:Animals; D016025:Bone Transplantation; D005269:Femur / Q000473:pathology / Q000601:surgery*; D007328:Insulin / Q000378:metabolism / Q000494:pharmacology*; D000078790:Insulin Secretion; D023421:Models, Animal; D010012:Osteogenesis; D051381:Rats; D011913:Rats, Inbred BB; D014184:Transplantation, Homologous
chemical_list: D007328:Insulin