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Reconstruction of critical size segmental femoral diaphyseal defects of New Zealand rabbits by using combined titanium mesh cage and induced membrane technique

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Long bone defects due to fractures resulting from high-energy trauma, infections and tumor resections are problems that orthopedic surgeons commonly face. We investigated the effects of a titanium mesh cage on bone healing with an induced membrane technique.

Methods

Three groups, each composed of eight rabbits, were formed. Extraarticular diaphyseal bone defects were created. Femora of the first group were fixed with an empty titanium mesh cage and two K-wires. After formation of the defect, polymethylmethacrylate was inserted and fixed with a K-wire in the second group. At the third week, the cement was removed, a sterilized cancellous graft-filled titanium mesh cage was placed into the defect, and the membrane that was previously formed over the cement was placed on the cage and repaired. In the third group, sterilized cancellous grafts were filled into the titanium mesh cage, and the titanium mesh cage was fitted into the bone defect area.

Results

At the end of the third month, all subjects were killed. Radiological data revealed that the healing of the bone in the second and third groups was significantly better than that in the first group. There was no difference between the second and third groups. A histological evaluation of the healing status, such as fibrous tissue, cartilage tissue and mature or immature bone formation, was performed. Histological healing in the second and third groups was also significantly better than that in the first group.

Conclusion

We concluded that the combination of membrane-induced bone healing and graft-filled titanium mesh cages expedites osteogenesis in extraarticular bone defects.

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Acknowledgements

This research funded by Çukurova University Scientific Research Projects Coordination Unit. Project number: TTU-2017-8360. Corresponding author Onur KAYA has received research support from Çukurova University Scientific Research Projects Coordination Unit. The other authors declare they have no financial interests.

Funding

We would like to thank Çukurova University Scientific Research Projects Coordination Unit for funding the study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic and Traumatology, Abdulkadir Yüksel State Hospital, 27100, Gaziantep, Turkey

    Onur Kaya

  2. Department of Orthopaedic and Traumatology, Medicine Faculty, Cukurova University, Çukurova University Balcalı Kampüs, 01330, Sarıçam, Adana, Turkey

    Akif Mirioglu, Cenk Ozkan, Omer Sunkar Bicer & Mustafa Tekin

  3. Department of Orthopaedic and Traumatology, Koc University Medicine Faculty, Topkapı, Koç Üniversitesi Hastanesi, Davutpaşa Cd. No:4, 34010, Zeytinburnu, Istanbul, Turkey

    Mehmet Ali Deveci

  4. Department of Pathology, Medicine Faculty, Cukurova University, Çukurova University Balcalı Kampüs, 01330, Sarıçam, Adana, Turkey

    Kivilcim Eren Ates

Authors
  1. Onur Kaya
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  2. Akif Mirioglu
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  3. Cenk Ozkan
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  4. Omer Sunkar Bicer
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  5. Mehmet Ali Deveci
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  6. Mustafa Tekin
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  7. Kivilcim Eren Ates
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Contributions

KO performed the animal experiments, funding acquisition,processed samples, analyzed and interpreted the data, and wrote the manuscript. MA processed samples, analyzed and interpreted the data, and wrote the manuscript. ÖSB, MAD, and MT supported in sample processing and supported in data analysis and interpretation. CÖ designed the study, guided the animal experiments, interpreted the data, and edited the manuscript. KEA analyzed pathological evaluation. All authors have revised the manuscript for important intellectual content and have approved the submission of the manuscript.

Corresponding author

Correspondence to Onur Kaya.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Animal study design

This study was performed in line with the principles of the Declaration of Helsinki.

Ethical approval

Ethical approval for this study was obtained from Ethics Committee of Cukurova University before the initiation of the study (27.10.2016/9).

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Kaya, O., Mirioglu, A., Ozkan, C. et al. Reconstruction of critical size segmental femoral diaphyseal defects of New Zealand rabbits by using combined titanium mesh cage and induced membrane technique. Eur J Orthop Surg Traumatol 33, 629–637 (2023). https://doi.org/10.1007/s00590-022-03330-y

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  • DOI: https://doi.org/10.1007/s00590-022-03330-y

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