Clinical trial and in-vitro study comparing the efficacy of treating bony lesions with allografts versus synthetic or highly-processed xenogeneic bone grafts

BMC Musculoskeletal Disorders

Research Article

Katja Nelson¹  Tobias Fretwurst¹  Laura Wolf²  Eva Johanna Kubosch²  Anke Bernstein²  Hagen Schmal³ 

[1] Department of Craniomaxillofacial Surgery, Albert-Ludwigs University Medical Center, Freiburg, Germany;Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Medical Center, Freiburg, Germany;Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Medical Center, Freiburg, Germany;Department of Orthopaedics and Traumatology, Odense University Hospital, Odense, Denmark;Department of Clinical Research, University of Southern Denmark, Odense, Denmark;

关键词: Bone substitute;    Bone filler;    Bone grafting;    Allograft;    Hydroxyapatite;    BioOss;    Clinical trial;    Biomarker;   

DOI  :  10.1186/s12891-016-0930-1

 received in 2015-09-11, accepted in 2016-02-06,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundOur study aim was to compare allogeneic cancellous bone (ACB) and synthetic or highly-processed xenogeneic bone substitutes (SBS) in the treatment of skeletal defects in orthopedic surgery.Methods232 patients treated for bony lesions with ACB (n = 116) or SBS (n = 116) within a 10-year time period were included in this case–control study. Furthermore, both materials were seeded with human osteoblasts (hOB, n = 10) and analyzed by histology, for viability (AlamarBlue®) and protein expression activity (Luminex®).ResultsThe complication rate was 14.2 %, proportion of defects without bony healing 3.6 %; neither outcome parameter differed comparing the intervention groups. Failed consolidation correlated with an increase in complications (p < 0.03). The rate of complications was further highly significant in association with the location of use (p < 0.001), but did not depend on age, ASA risk classification, BMI, smoking behavior or type of insurance. However, those factors did significantly influence the bony healing rate (p < 0.02). Complication and consolidation rates were independent of gender and the filling substances employed within the different locations. Histological examination revealed similar bone structures, whereas cell remnants were apparent only in the allografts. Both materials were biocompatible in-vitro, and seeded with human osteoblasts. The cells remained vital over the 3-week culture period and produced microscopically typical bone matrix. We observed initially increased expression of osteocalcin, osteopontin, and osteoprotegerin as well as leptin and adiponectin secretion declining after 1 week, especially in the ACB group.ConclusionAlthough both investigated materials appeared to be similarly suitable for the treatment of skeletal lesions in-vivo and in-vitro, outcome was decisively influenced by other factors such as the site of use or epidemiological parameters.

【 授权许可】

CC BY   
© Kubosch et al. 2016