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The Advantages of Bilateral Osteotomy Over Unilateral Osteotomy for Osteoporotic Bone Healing

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Abstract

Most models of osteoporotic bone fractures are performed unilaterally (UL). We investigated healing of tibia osteotomy performed either UL or bilaterally (BL) in ovariectomized rats. Behavior of animals and muscle structure were assessed. Three-month-old female Sprague-Dawley rats were ovariectomized (n = 32). After 10 weeks, half the rats underwent UL osteotomy of tibia metaphysis (right limb) with plate osteosynthesis. The other rats were osteotomized BL. Half of the rats in each group received either standard pain treatment with carprofen (5 mg/kg body weight (BW), 1x/day for 2 days) or carprofen and buprenorphine (5 mg/kg BW, 1x/day and 0.03 mg/kg BW, 2x/day for 5 days) after osteotomy. The UL rats started to load the injured limb from day 27 ± 9; BL rats did this from day 4 ± 4 onward. The UL rats more frequently loaded only one hind limb; BL rats more often loaded both hind limbs. Osteotomy was not bridged in 20% of UL rats and in 4% of BL rats. Callus volume and bone volume fraction were lower in UL group. Weight and fiber size of UL-intact limb muscles were enhanced, compared to the osteotomized limb and those in BL group. Most of the other parameters which assess physiology, activity, body posture, head, or coat were not different. The effect of two pain therapies was not significant on any variable studied. Welfare of the animals was acceptable in all rats. In UL rats, bone healing was delayed. The more advanced healing in BL rats suggested a positive effect of earlier loading. In studies on bone healing, it is advisable to perform BL osteotomy.

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Acknowledgements

The authors are grateful to their colleagues, R. Castro-Machguth, A. Witt, and R. Wigger, for technical support. We are thankful to Dr. V. Reupke for help in preparing a score sheet. We would like to acknowledge the important role of Herr Dr. T. Rack in the developing of bone analyses in the last decade.

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Authors and Affiliations

  1. Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center, Robert-Koch 40, 37075, Goettingen, Germany

    M. Komrakova, J. Fiebig, D. B. Hoffmann, W. Lehmann, K. M. Stuermer & S. Sehmisch

  2. Department of Animal Sciences, University of Goettingen, Albrecht-Thaer-Weg 3, 37075, Goettingen, Germany

    C. Krischek

  3. Institute of Food Quality and Safety, Foundation University of Veterinary Medicine, Bischofsholer Damm 15, 30173, Hanover, Germany

    C. Krischek

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  1. M. Komrakova
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  2. J. Fiebig
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  3. D. B. Hoffmann
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Correspondence to M. Komrakova.

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Conflict of interest

M Komrakova, J Fiebig, D Hoffmann, C Krischek, W Lehmann, KM Stuermer, and S Sehmisch declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

The animal study protocol was approved by the local regional government (33.4-42502-04-14/1396, Oldenburg, Germany) in accordance with German animal protection laws prior to performing the study.

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Komrakova, M., Fiebig, J., Hoffmann, D.B. et al. The Advantages of Bilateral Osteotomy Over Unilateral Osteotomy for Osteoporotic Bone Healing. Calcif Tissue Int 103, 80–94 (2018). https://doi.org/10.1007/s00223-018-0392-6

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