A novel method for lateral callus distraction and its importance for the mechano-biology of bone formation |
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| Authors: | L. Claes A. Veeser M. Göckelmann D. Horvath L. Dürselen A. Ignatius |
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| Affiliation: | 1. Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research, University of Ulm, Germany;2. Jestetten, Germany;1. Department of Radiology & Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA;2. National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA;1. Department of Mathematics and Actuarial Science, Indiana University Northwest, 3400 Broadway, Gary, IN 46408, USA;2. Departamento de Física, Cinvestav, A.P. 14-740, 07000 México D.F., Mexico;3. Departamento de Física Teórica, Atómica y Óptica and IMUVA, Universidad de Valladolid, E-47011 Valladolid, Spain;1. Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic;2. Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic;3. Department of Surgery, University Hospital and Medical School, Pilsen, Czech Republic;1. Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands;2. Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands;1. Department of Electrical and Computer Engineering, University of Central Florida, HEC #416, Orlando, FL 32816, USA;2. Berkeley Wireless Research Center, 2108 Allston Way, Suite 200, Berkeley, CA 94704, USA;3. Department of Electrical and Computer Engineering, University of Central Florida, HEC #310, Orlando, FL 32816, USA;4. Computer Science Division, University of California, 631 Soda Hall, Berkeley, CA 94720-1776, USA |
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| Abstract: | We introduce a novel method of lateral callus distraction for bone formation, which avoids the conventional splitting and weakening of bones. At the medial aspect of the sheep tibia the periosteum was resected and small holes were drilled into the cortex to connect the bone surface with the marrow. A distraction device with a hydroxyapatite-coated titanium plate was fixed over the drilled area. After 10 days latency the plate was distracted perpendicular to the bone's long axis twice a day by 0.27 mm for 10 days. The newly formed tissue was then allowed 50 days of maturation. In a control group the plate was fixed 5.4 mm distant from the bone surface. After 70 days all sheep were sacrificed and investigated histo-morphologically and with pQCT.Significantly more bone had developed between the lateral bone surface and the plate in the distraction group compared to the control group. There was exclusively intra-membranous bone formation with trabeculae oriented in the direction of the applied distraction. The main calcification occurred weeks after the last distraction. In conventional callus distraction the tissue strain caused by distraction is superimposed by the tissue deformation due to the deformation of the fixation device. In contrast, in the newly introduced lateral callus distraction method pure uniaxial strain occurs. From a mechano-biological point of view these results suggest that pure uniaxial strain induces exclusively intra-membranous bone formation. Furthermore, it shows that the anabolic effect of tissue strain is present even 50 days after the last stimulation by distraction. |
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