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Erschienen in: Clinical Orthopaedics and Related Research® 11/2011

01.11.2011 | Symposium: Bone Repair and Regeneration

Influence of Gender and Fixation Stability on Bone Defect Healing in Middle-aged Rats: A Pilot Study

verfasst von: Manav Mehta, PhD, Georg N. Duda, PhD, Carsten Perka, MD, Patrick Strube, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 11/2011

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Abstract

Background

Gender and stability of fixation independently influence bone regeneration but their combined effects are unclear.

Questions/purposes

In a pilot study we determined the combined influence of gender and fixation stability on the callus of middle-aged rats regarding (1) biomechanical properties; (2) bridging over time; (3) callus formation; and (4) callus size, geometry, mineralization, and microstructure.

Methods

We osteotomized the left femur of 32 Sprague-Dawley rats (12 months old). Femurs were externally fixed with a gap of 1.5 mm in four groups of eight animals each: female semirigid, male semirigid, female rigid, and male rigid. Qualitative and quantitative in vivo radiographic analyses were performed twice weekly. Six weeks postoperatively, harvested femora were evaluated using micro-CT and biomechanical testing.

Results

Torsional stiffness and maximum torque at failure were higher in male and in semirigidly fixed fractures. Radiographic analysis revealed earlier bridging and callus formation in both male groups. Micro-CT analysis showed a larger callus size, altered geometry, and microstructure in males and semirigidly fixed animals, whereas mineralization was similar in all animals.

Conclusion

Our data suggest female gender represents an independent risk factor for bone healing in middle-aged rats. Although healing in females was delayed compared with males, they exhibited a similar response (superior callus properties) to a more semirigid fixation.

Clinical Relevance

While female gender appears to reflect a risk for impaired bone healing in middle-aged female rats, clinical studies would be required to confirm the finding in humans.
Literatur
1.
Zurück zum Zitat Carter DR, Beaupre GS, Giori NJ, Helms JA. Mechanobiology of skeletal regeneration. Clin Orthop Relat Res. 1998;355(Suppl):S41–55.PubMedCrossRef Carter DR, Beaupre GS, Giori NJ, Helms JA. Mechanobiology of skeletal regeneration. Clin Orthop Relat Res. 1998;355(Suppl):S41–55.PubMedCrossRef
2.
Zurück zum Zitat Chang MA, Bishop AT, Moran SL, Shin AY. The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg [Am]. 2006;31:387–396.CrossRef Chang MA, Bishop AT, Moran SL, Shin AY. The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg [Am]. 2006;31:387–396.CrossRef
3.
Zurück zum Zitat Claes LE, Heigele CA, Neidlinger-Wilke C, Kaspar D, Seidl W, Margevicius KJ, Augat P. Effects of mechanical factors on the fracture healing process. Clin Orthop Relat Res. 1998;355(Suppl):S132–147.PubMedCrossRef Claes LE, Heigele CA, Neidlinger-Wilke C, Kaspar D, Seidl W, Margevicius KJ, Augat P. Effects of mechanical factors on the fracture healing process. Clin Orthop Relat Res. 1998;355(Suppl):S132–147.PubMedCrossRef
4.
Zurück zum Zitat Currey J. Measurement of the mechanical properties of bone: a recent history. Clin Orthop Relat Res. 2009;467:1948–1954.PubMedCrossRef Currey J. Measurement of the mechanical properties of bone: a recent history. Clin Orthop Relat Res. 2009;467:1948–1954.PubMedCrossRef
5.
Zurück zum Zitat David V, Lafage-Proust MH, Laroche N, Christian A, Ruegsegger P, Vico L. Two-week longitudinal survey of bone architecture alteration in the hindlimb-unloaded rat model of bone loss: sex differences. Am J Physiol Endocrinol Metab. 2006;290:E440–447.PubMedCrossRef David V, Lafage-Proust MH, Laroche N, Christian A, Ruegsegger P, Vico L. Two-week longitudinal survey of bone architecture alteration in the hindlimb-unloaded rat model of bone loss: sex differences. Am J Physiol Endocrinol Metab. 2006;290:E440–447.PubMedCrossRef
6.
Zurück zum Zitat Goodship AE, Kenwright J. The influence of induced micromovement upon the healing of experimental tibial fractures. J Bone Joint Surg Br. 1985;67:650–655.PubMed Goodship AE, Kenwright J. The influence of induced micromovement upon the healing of experimental tibial fractures. J Bone Joint Surg Br. 1985;67:650–655.PubMed
7.
Zurück zum Zitat Gruber R, Koch H, Doll BA, Tegtmeier F, Einhorn TA, Hollinger TO. Fracture healing in the elderly patient. Exp Gerontol. 2006;41:1080–1093.PubMedCrossRef Gruber R, Koch H, Doll BA, Tegtmeier F, Einhorn TA, Hollinger TO. Fracture healing in the elderly patient. Exp Gerontol. 2006;41:1080–1093.PubMedCrossRef
8.
Zurück zum Zitat Haas NP. Callus modulation—fiction or reality? [in German]. Der Chirurg Zeitschrift für alle Gebiete der operativen Medizin. 2000;71:987–988. Haas NP. Callus modulation—fiction or reality? [in German]. Der Chirurg Zeitschrift für alle Gebiete der operativen Medizin. 2000;71:987–988.
9.
Zurück zum Zitat Kaspar K, Schell H, Toben D, Matziolis G, Bail HJ. An easily reproducible and biomechanically standardized model to investigate bone healing in rats, using external fixation. Biomed Tech (Berl). 2007;52:383–390.CrossRef Kaspar K, Schell H, Toben D, Matziolis G, Bail HJ. An easily reproducible and biomechanically standardized model to investigate bone healing in rats, using external fixation. Biomed Tech (Berl). 2007;52:383–390.CrossRef
10.
Zurück zum Zitat Kraus KH, Kadiyala S, Wotton H, Kurth A, Shea M, Hannan M, Hayes WC, Kirker-Head CA, Bruder S. Critically sized osteo-periosteal femoral defects: a dog model. J Invest Surg. 1999;12:115–124.PubMedCrossRef Kraus KH, Kadiyala S, Wotton H, Kurth A, Shea M, Hannan M, Hayes WC, Kirker-Head CA, Bruder S. Critically sized osteo-periosteal femoral defects: a dog model. J Invest Surg. 1999;12:115–124.PubMedCrossRef
11.
Zurück zum Zitat Li Z, Zhang W, Li ZB, Li JR. Abnormal union of mandibular fractures: a review of 84 cases. J Oral Maxillofac Surg. 2006;64:1225–1231.PubMedCrossRef Li Z, Zhang W, Li ZB, Li JR. Abnormal union of mandibular fractures: a review of 84 cases. J Oral Maxillofac Surg. 2006;64:1225–1231.PubMedCrossRef
12.
Zurück zum Zitat Lienau J, Schell H, Duda GN, Seebeck P, Muchow S, Bail HJ. Initial vascularization and tissue differentiation are influenced by fixation stability. J Orthop Res. 2005;23:639–645.PubMedCrossRef Lienau J, Schell H, Duda GN, Seebeck P, Muchow S, Bail HJ. Initial vascularization and tissue differentiation are influenced by fixation stability. J Orthop Res. 2005;23:639–645.PubMedCrossRef
13.
Zurück zum Zitat Mehta M, Strube P, Peters A, Perka C, Hutmacher D, Fratzl P, Duda GN. Influences of age and mechanical stability on volume, microstructure, and mineralization of fracture callus during bone healing: is osteoclast activity the key to age-related impaired healing? Bone. 2010;47:219–228.PubMedCrossRef Mehta M, Strube P, Peters A, Perka C, Hutmacher D, Fratzl P, Duda GN. Influences of age and mechanical stability on volume, microstructure, and mineralization of fracture callus during bone healing: is osteoclast activity the key to age-related impaired healing? Bone. 2010;47:219–228.PubMedCrossRef
14.
Zurück zum Zitat Meyer MH, Meyer RA Jr. Genes with greater up-regulation in the fracture callus of older rats with delayed healing. J Orthop Res. 2007;25:488–494.PubMedCrossRef Meyer MH, Meyer RA Jr. Genes with greater up-regulation in the fracture callus of older rats with delayed healing. J Orthop Res. 2007;25:488–494.PubMedCrossRef
15.
Zurück zum Zitat Mora G, Forriol F. Mechanical analysis of the healing of different osteotomies fixed externally. Int Orthop. 2000;24:295–298.PubMedCrossRef Mora G, Forriol F. Mechanical analysis of the healing of different osteotomies fixed externally. Int Orthop. 2000;24:295–298.PubMedCrossRef
16.
Zurück zum Zitat Parker MJ, Raghavan R, Gurusamy K. Incidence of fracture-healing complications after femoral neck fractures. Clin Orthop Relat Res. 2007;458:175–179.PubMed Parker MJ, Raghavan R, Gurusamy K. Incidence of fracture-healing complications after femoral neck fractures. Clin Orthop Relat Res. 2007;458:175–179.PubMed
17.
Zurück zum Zitat Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br. 2002;84:1093–1110.PubMedCrossRef Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br. 2002;84:1093–1110.PubMedCrossRef
18.
Zurück zum Zitat Rubin CT, Bain SD, McLeod KJ. Suppression of the osteogenic response in the aging skeleton. Calcif Tissue Int. 1992;50:306–313.PubMedCrossRef Rubin CT, Bain SD, McLeod KJ. Suppression of the osteogenic response in the aging skeleton. Calcif Tissue Int. 1992;50:306–313.PubMedCrossRef
19.
Zurück zum Zitat Schell H, Epari DR, Kassi JP, Bragulla H, Bail HJ, Duda GN. The course of bone healing is influenced by the initial shear fixation stability. J Orthop Res. 2005;23:1022–1028.PubMedCrossRef Schell H, Epari DR, Kassi JP, Bragulla H, Bail HJ, Duda GN. The course of bone healing is influenced by the initial shear fixation stability. J Orthop Res. 2005;23:1022–1028.PubMedCrossRef
20.
Zurück zum Zitat Schmidmaier G, Wildemann B, Melis B, Krummrey G, Einhorn TA, Haas NP, Raschke M. Development and characterization of a standard closed tibial fracture model in the rat. Eur J Trauma. 2004;30:35–42.CrossRef Schmidmaier G, Wildemann B, Melis B, Krummrey G, Einhorn TA, Haas NP, Raschke M. Development and characterization of a standard closed tibial fracture model in the rat. Eur J Trauma. 2004;30:35–42.CrossRef
21.
Zurück zum Zitat Sprague S, Bhandari M. An economic evaluation of early versus delayed operative treatment in patients with closed tibial shaft fractures. Arch Orthop Trauma Surg. 2002;122:315–323.PubMed Sprague S, Bhandari M. An economic evaluation of early versus delayed operative treatment in patients with closed tibial shaft fractures. Arch Orthop Trauma Surg. 2002;122:315–323.PubMed
22.
Zurück zum Zitat Strube P, Mehta M, Baerenwaldt A, Trippens J, Wilson CJ, Ode A, Perka C, Duda G, Kasper G. Sex-specific compromised bone healing in female rats might be associated with a decrease in mesenchymal stem cell quantity. Bone. 2009;45:1065–1072.PubMedCrossRef Strube P, Mehta M, Baerenwaldt A, Trippens J, Wilson CJ, Ode A, Perka C, Duda G, Kasper G. Sex-specific compromised bone healing in female rats might be associated with a decrease in mesenchymal stem cell quantity. Bone. 2009;45:1065–1072.PubMedCrossRef
23.
Zurück zum Zitat Strube P, Mehta M, Putzier M, Matziolis G, Perka C, Duda GN. A new device to control mechanical environment in bone defect healing in rats. J Biomech. 2008;41:2696–2702.PubMedCrossRef Strube P, Mehta M, Putzier M, Matziolis G, Perka C, Duda GN. A new device to control mechanical environment in bone defect healing in rats. J Biomech. 2008;41:2696–2702.PubMedCrossRef
24.
Zurück zum Zitat Strube P, Sentuerk U, Riha T, Kaspar K, Mueller M, Kasper G, Matziolis G, Duda GN, Perka C. Influence of age and mechanical stability on bone defect healing: age reverses mechanical effects. Bone. 2008;42:758–764.PubMedCrossRef Strube P, Sentuerk U, Riha T, Kaspar K, Mueller M, Kasper G, Matziolis G, Duda GN, Perka C. Influence of age and mechanical stability on bone defect healing: age reverses mechanical effects. Bone. 2008;42:758–764.PubMedCrossRef
25.
Zurück zum Zitat Turner CH, Takano Y, Owan I. Aging changes mechanical loading thresholds for bone formation in rats. J Bone Miner Res. 1995;10:1544–1549.PubMedCrossRef Turner CH, Takano Y, Owan I. Aging changes mechanical loading thresholds for bone formation in rats. J Bone Miner Res. 1995;10:1544–1549.PubMedCrossRef
26.
Zurück zum Zitat White AA 3rd, Panjabi MM, Southwick WO. The four biomechanical stages of fracture repair. J Bone Joint Surg Am. 1977;59:188–192.PubMed White AA 3rd, Panjabi MM, Southwick WO. The four biomechanical stages of fracture repair. J Bone Joint Surg Am. 1977;59:188–192.PubMed
27.
Zurück zum Zitat Yamagishi M, Yoshimura Y. The biomechanics of fracture healing. J Bone Joint Surg Am. 1955;37:1035–1068.PubMed Yamagishi M, Yoshimura Y. The biomechanics of fracture healing. J Bone Joint Surg Am. 1955;37:1035–1068.PubMed
28.
Zurück zum Zitat Zlowodzki M, Obremskey WT, Thomison JB, Kregor PJ. Functional outcome after treatment of lower-extremity nonunions. J Trauma. 2005;58:312–317.PubMedCrossRef Zlowodzki M, Obremskey WT, Thomison JB, Kregor PJ. Functional outcome after treatment of lower-extremity nonunions. J Trauma. 2005;58:312–317.PubMedCrossRef
Metadaten
Titel
Influence of Gender and Fixation Stability on Bone Defect Healing in Middle-aged Rats: A Pilot Study
verfasst von
Manav Mehta, PhD
Georg N. Duda, PhD
Carsten Perka, MD
Patrick Strube, MD
Publikationsdatum
01.11.2011
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 11/2011
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-011-1914-y

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