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Axially vascularized bone substitutes: a systematic review of literature and presentation of a novel model

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Abstract

Introduction

The creation of axially vascularized bone substitutes (AVBS) has been successfully demonstrated in several animal models. One prototypical indication is bone replacement in patients with previously irradiated defect sites, such as in the mandibular region. The downside of current clinical practice, when free fibular or scapular grafts are used, is the creation of significant donor site morbidity.

Methods

Based on our previous experiments, we extended the creation of an arterio-venous loop to generate vascularized bone substitutes to a new defect model in the goat mandibula. In this report, we review the literature regarding different models for axially vascularized bone substitutes and present a novel model demonstrating the feasibility of combining this model with synthetic porous scaffold materials and biological tissue adhesives to grow cells and tissue.

Results

We were able to show the principal possibility to generate axially vascularized bony substitutes in vivo in goat mandibular defects harnessing the regenerative capacity of the living organism and completely avoiding donor site morbidity.

Conclusion

From our findings, we conclude that this novel model may well offer new perspectives for orthopedic and traumatic bone defects that might benefit from the reduction of donor site morbidity.

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Acknowledgments

The mandibular reconstruction study was funded by a research grant from the University of Alexandria (Alexandria University Research Enhancement Program; Alex REP, code HLTH-09). The authors would like to acknowledge with great appreciation the team of Abou Elnaga Laboratories in Alexandria, namely Dr. Sahdy Foad for help with the PRP protocol standardization. The animal experiments were approved by the ethics committee of the University of Alexandria and complied with the current laws of the local governmental authorities.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Head and Neck and Endocrine Surgery, University of Alexandria, ElKhartoom square, Elazarita, Alexandria, Egypt

    A. M. Eweida, A. S. Nabawi, H. A. Elhammady, M. R. Khalil & M. S. Shawky

  2. Tissue Engineering Laboratories, Faculty of Dentistry, University of Alexandria, Champillion street, Elazarita, Alexandria, Egypt

    M. K. Marei

  3. Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Erlangen-Nürnberg, Krankenhausstrasse 12, 91054, Erlangen, Germany

    A. Arkudas, J. P. Beier, U. Kneser & R. E. Horch

  4. Department of Hand Surgery, Vulpius Medical Centre, Vulpiusstrasse 29, 74906, Bad Rappenau, Germany

    F. Unglaub

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  1. A. M. Eweida
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  2. A. S. Nabawi
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  3. H. A. Elhammady
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  4. M. K. Marei
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  5. M. R. Khalil
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  6. M. S. Shawky
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  7. A. Arkudas
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  8. J. P. Beier
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  9. F. Unglaub
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  10. U. Kneser
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  11. R. E. Horch
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Correspondence to A. M. Eweida.

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Eweida, A.M., Nabawi, A.S., Elhammady, H.A. et al. Axially vascularized bone substitutes: a systematic review of literature and presentation of a novel model. Arch Orthop Trauma Surg 132, 1353–1362 (2012). https://doi.org/10.1007/s00402-012-1550-3

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