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Effect of VEGF-A165 addition on the integration of a cortical allograft in a tibial segmental defect in rabbits

  • Experimental Study
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Long-bone segmental defects caused by infection, fracture, or tumour are a challenge for orthopaedic surgeons. Structural allografts are sometimes used in their treatment but their poor biological characteristics are a liability. The objective of this study was to determine whether the addition of recombinant vascular endothelial growth factor-A (VEGF) to a structural allograft improved its integration into a rabbit tibial segmental defect in a non-union model.

Methods

Tibial segmental defects were filled with heat sterilized allogenic tubular tibiae sections and then stabilized with a screw plate. In the VEGF treatment group (n = 6 tibiae), 2 μg of VEGF added to a 50 μl matrigel solution was inserted into the allograft cavity. In the control group (n = 6 tibiae), only matrigel was added. After 12 weeks, macroscopic and microscopic analysis, radiographs, and computerized micro-tomography (micro-CT) were performed. If allograft consolidation was present, a torsional resistance analysis was performed.

Results

Addition of VEGF to the allograft decreased the rate of osteosynthesis failure compared with the control group (1/6 vs. 5/6, p = 0.08), increased trabecular continuity evaluated by micro-CT in the bone–allograft interphases (8/12 vs. 2/12, p = 0.036) and histological trabecular continuity (7/12 vs. 0/12, p = 0.0046). Full consolidation was observed in three tibiae of the VEGF group and one in the control group (differences not significant); however, torsional resistance showed no significant differences (n.s.).

Conclusion

Addition of VEGF to a structural allograph inserted into a rabbit tibial segmental defect increased allograft integration rate. Further research in this direction might help clinicians in dealing with large bone defects.

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Acknowledgments

This study has been funded by grants provided by the Association Internationale pourl′Ostéosynthèse Dynamique and the Sociedad Española de Cirugía Ortopédica y Traumatología.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Trauma, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain

    Miguel Angel Ruiz-Ibán, Fausto Gonzalez-Lizán & Jorge Diaz-Heredia

  2. Department of Anesthesiology and Reanimation, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain

    Maria Elena Elías-Martin

  3. Experimental Surgery Unit, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain

    Carlos Correa Gorospe

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  1. Miguel Angel Ruiz-Ibán
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  2. Fausto Gonzalez-Lizán
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  3. Jorge Diaz-Heredia
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  4. Maria Elena Elías-Martin
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  5. Carlos Correa Gorospe
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Correspondence to Miguel Angel Ruiz-Ibán.

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Ruiz-Ibán, M.A., Gonzalez-Lizán, F., Diaz-Heredia, J. et al. Effect of VEGF-A165 addition on the integration of a cortical allograft in a tibial segmental defect in rabbits. Knee Surg Sports Traumatol Arthrosc 23, 1393–1400 (2015). https://doi.org/10.1007/s00167-013-2785-4

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