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The Journal of Bone and Joint Surgery, Vol 66, Issue 2 274-279, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
The healing of segmental bone defects induced by demineralized bone matrix. A radiographic and biomechanical study
TA Einhorn, JM Lane, AH Burstein, CR Kopman and VJ Vigorita
We studied the effect of demineralized bone matrix on the repair of large
femoral diaphyseal defects in a rat model by clinical, radiographic, and
biomechanical methods. A standard procedure was first developed to create
segmental defects that did not heal and in which non-union developed
consistently. The effect of demineralized bone matrix on repair was then
assessed by physical examination, serial radiographs, and biomechanical
studies to determine deformation to failure, stiffness, torsional strength,
and energy absorption. By twelve weeks, the defects that had been treated
with demineralized bone matrix showed satisfactory repair and remodeling in
most animals based on clinical and radiographic evaluation. The
biomechanical studies demonstrated that the bone induced by demineralized
bone matrix had an energy-absorption capacity and stiffness equal to those
of intact rat femoral bone. The bone induced by demineralized bone matrix
achieved 35 per cent of the torsional strength of normal bone and an
increased capacity to deform under load. These biomechanical properties are
similar to those observed in the early stages of normal fracture repair.
Clinical Relevance: An effective, readily available alternative to
autologous bone-graft material would have a variety of clinical uses in
orthopaedic surgery, such as augmenting fusions, aiding in the repair of
high-risk fractures, and filling or bridging bone defects. Demineralized
bone matrix may provide an important tool for these purposes by inducing
bone that has the mechanical properties of fracture callus. This would
reduce the morbidity associated with harvesting autologous bone and have an
advantage over allografts or synthetic biomaterials that require
incorporation by the host before they can support mechanical loads.
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