title: Scintigraphic evaluation of the osteoblastic activity of rabbit tibial defects after HYAFF11 membrane application.
abstract: BACKGROUND
  An unfavorable condition for bone healing is the presence of bone defects. Under such conditions, a material can play a role to cover fractured or defective bone. Technological advances now allow for the use of such material. Hyalonect(®) (Fidia Advanced Biopolymers SLR, Italy), a novel membrane comprising knitted fibers of esterified hyaluronan (HYAFF11) can be used to cover fractured or grafted bone and can also serve as a scaffold to keep osteoprogenitor cells in place. The aim of this study was to compare osteoblastic activity by the use of scintigraphic methods in defective rabbit tibias during early-phase bone healing with or without a hyaluronan-based mesh.
  
  
  METHODS
  Two groups (A and B) of New Zealand albino rabbits were used; each group included 10 animals. Operations on all rabbits were performed under general anesthesia. We also resected 10-mm bone segments from each animal's tibial diaphysis. After resection, tibias with defects were fixed using Kirschner wires. In group A, no hyaluronan-based mesh was used. In group B, tibial segmental defects were enclosed with a hyaluronan-based mesh. The rabbits were followed up for 4 weeks postoperatively, after which bone scintigraphic studies were performed on each animal to detect and compare osteoblastic activity.
  
  
  RESULTS
  The mean count in the fracture side of the hyaluronan-based mesh group was significantly higher compared to that of the group A (p = 0.019). However, there was no significant difference between group B and control rabbits with respect to the mean count on the intact bone side (p = 0.437). The bone defect (fracture)/intact bone mean count ratio was significantly higher in group B compared to group A (p = 0.008).
  
  
  CONCLUSIONS
  A hyaluronan-based mesh plays a role in promoting osteoblastic activity. Hyalonect(®) is suitable for restoring tissue continuity whenever the periosteal membrane is structurally impaired or inadequate. Our results demonstrated that, during early-phase bone healing, osteoblastic activity was increased in bone defect sites when a hyaluronan-based mesh was also used. The most important aspect of this study concerns its scintigraphy-based design. This study is the first to use a scintigraphic method to demonstrate the effectiveness of hyaluronic acid-based material for bone healing.
authors.affiliation: Department of Orthopaedics and Traumatology, Medical School, Bozok University, Yozgat, Turkey. drugurmermerkaya@gmail.com.
authors.forename: Musa Uğur
authors.initials: MU
authors.lastname: Mermerkaya
authors.affiliation: Department of Orthopaedics and Traumatology, Medical School, Hacettepe University, Ankara, Turkey.
authors.forename: Mahmut Nedim
authors.initials: MN
authors.lastname: Doral
authors.affiliation: Department of Orthopaedics and Traumatology, Medical School, Bozok University, Yozgat, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Karaaslan
authors.affiliation: Department of Orthopaedics and Traumatology, Medical School, Hacettepe University, Ankara, Turkey.
authors.forename: Gazi
authors.initials: G
authors.lastname: Huri
authors.affiliation: Department of Nuclear Medicine, Medical School, Bozok University, Yozgat, Turkey.
authors.forename: Seyhan
authors.initials: S
authors.lastname: Karacavuş
authors.affiliation: Department of Orthopaedics and Traumatology, Medical School, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Kaymaz
authors.affiliation: Department of Orthopaedics and Traumatology, Yalvaç State Hospital, Isparta, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Alkan
mesh_terms: D000818:Animals; D017102:Fracture Healing / Q000187:drug effects*; D006820:Hyaluronic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D008297:Male; D010006:Osteoblasts / Q000187:drug effects*; D011817:Rabbits; D011877:Radionuclide Imaging; D013526:Surgical Mesh; D013977:Tibia / Q000187:drug effects; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: C086358:hyaluronic acid benzyl ester; D006820:Hyaluronic Acid
keywords: Bone healing; Bone scintigraphy; Hyaluronan-based mesh; Osteoblastic activity