Surgical Revascularization Induces Angiogenesis in Orthotopic Bone Allograft
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- 作者：Wouter F. Willems MD (1)
Thomas Kremer MD (1)
Patricia Friedrich AAS (1)
Allen T. Bishop MD (1) - 刊名：Clinical Orthopaedics and Related Research?
- 出版年：2012
- 出版时间：September 2012
- 年：2012
- 卷：470
- 期：9
- 页码：2496-2502
- 全文大小：437KB
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Thomas Kremer MD (1)
Patricia Friedrich AAS (1)
Allen T. Bishop MD (1)
1. Microvascular Research Laboratory, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA
文摘
Background Remodeling of structural bone allografts relies on adequate revascularization, which can theoretically be induced by surgical revascularization. We developed a new orthotopic animal model to determine the technical feasibility of axial arteriovenous bundle implantation and resultant angiogenesis. Questions/purposes We asked whether arteriovenous bundles implanted in segmental allografts would increase cortical blood flow and angiogenesis compared to nonrevascularized frozen bone allografts and contralateral femoral controls. Methods We performed segmental femoral allotransplantation orthotopically from 10 Brown Norway rats to 20 Lewis rats. Ten rats each received either bone allograft reconstruction alone (Group I) or allograft combined with an intramedullary saphenous arteriovenous flap (Group II). At 16?weeks, we measured cortical blood flow with the hydrogen washout method. We then quantified angiogenesis using capillary density and micro-CT vessel volume measurements. Results All arteriovenous bundles were patent. Group II had higher mean blood flow (0.12?mL/minute/100?g versus 0.05?mL/minute/100?g), mean capillary density (23.6% versus 2.8%), and micro-CT vessel volume (0.37?mm3 versus 0.07?mm3) than Group I. Revascularized allografts had higher capillary density than untreated contralateral femora, while vessel volume did not differ and blood flow was lower. Conclusions Axial surgical revascularization in orthotopic allotransplants can achieve strong angiogenesis and increases cortical bone blood flow. Clinical Relevance Poor allograft revascularization results in frequent complications of nonunion, infection, and late stress fracture. The presented technique of surgical revascularization could therefore offer a beneficial adjunct to clinical segmental bone allografting.