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The Otto Aufranc Award: Demineralized Bone Matrix Around Porous Implants Promotes Rapid Gap Healing and Bone Ingrowth

  • Symposium: Papers Presented at the Annual Meetings of The Hip Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Noncemented revision arthroplasty is often complicated by the presence of bone implant gaps that reduce initial stability and biologic fixation. Demineralized bone matrix has osteoinductive properties and therefore the potential to enhance gap healing and porous implant fixation.

Questions/purposes

We determined at what times and to what extent demineralized bone matrix promotes gap healing and bone ingrowth around a porous implant.

Methods

We inserted porous titanium implants into the proximal metaphyses of canine femora and humeri, with an initial 3-mm gap between host cancellous bone and implants. We left the gaps empty (control; n = 12) or filled them with either demineralized bone matrix (n = 6) or devitalized demineralized bone matrix (negative control; n = 6) and left them in situ for 4 or 12 weeks. We quantified volume healing of the gap with new bone using three-dimensional micro-CT scanning and quantified apposition and ingrowth using backscattered scanning electron microscopy.

Results

The density of bone inside gaps filled with demineralized bone matrix reached 64% and 93% of surrounding bone density by 4 and 12 weeks, respectively. Compared with empty controls and negative controls at 4 and 12 weeks, gap healing using demineralized bone matrix was two to three times greater and bone ingrowth and apposition were up to 15 times greater.

Conclusions

Demineralized bone matrix promotes rapid bone ingrowth and gap healing around porous implants.

Clinical Relevance

Demineralized bone matrix has potential for enhancing implant fixation in revision arthroplasty.

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Acknowledgments

The authors thank the National Research Council Canada for manufacturing and donating the implants, Osteotech Inc for provision of the canine DBM material, and Dr. Lawrence Joseph for professional statistical advice. The authors also thank Eric Baril, PhD, and Fabrice Bernier, PhD, at the National Research Council Canada for their invaluable instruction on micro-CT scanning and S. Adam Hacking, PhD, for assistance with image analysis.

Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery, Faculty of Medicine, McGill University, Montreal, QC, Canada

    Letitia Lim MD, J. Dennis Bobyn PhD, Kristian M. Bobyn BA & Michael Tanzer MD

  2. Jo Miller Orthopaedic Research Laboratory, Montreal General Hospital, 1650 Cedar Avenue, Room LS1-409, Montreal, QC, H3G1A4, Canada

    Letitia Lim MD, J. Dennis Bobyn PhD, Kristian M. Bobyn BA & Michael Tanzer MD

  3. National Research Council Canada, Boucherville, QC, Canada

    Louis-Philippe Lefebvre MEng

Authors
  1. Letitia Lim MD
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  2. J. Dennis Bobyn PhD
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  3. Kristian M. Bobyn BA
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  4. Louis-Philippe Lefebvre MEng
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  5. Michael Tanzer MD
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Corresponding author

Correspondence to J. Dennis Bobyn PhD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. The institution of one or more of the authors (LL, JDB, KMB, MT) has received funding from the Canadian Institutes of Health Research.

Each author certifies that his or her institution approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at McGill University.

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Lim, L., Bobyn, J.D., Bobyn, K.M. et al. The Otto Aufranc Award: Demineralized Bone Matrix Around Porous Implants Promotes Rapid Gap Healing and Bone Ingrowth. Clin Orthop Relat Res 470, 357–365 (2012). https://doi.org/10.1007/s11999-011-2011-y

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  • DOI: https://doi.org/10.1007/s11999-011-2011-y

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