1. Effect of VEGF-A165 addition on the integration of a cortical allograft in a tibial segmental defect in rabbits
- Author
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Fausto Gonzalez-Lizán, Miguel Ángel Ruiz-Ibán, Jorge Díaz-Heredia, Carlos Correa Gorospe, and Maria Elena Elías-Martin
- Subjects
Vascular Endothelial Growth Factor A ,medicine.medical_specialty ,Radiography ,VEGF receptors ,Bone Screws ,Non union ,Fracture Fixation, Internal ,Osseointegration ,Animals ,Medicine ,Orthopedics and Sports Medicine ,Tibia ,Fracture Healing ,Matrigel ,Bone Transplantation ,Osteosynthesis ,biology ,business.industry ,Allografts ,Surgery ,Tibial Fractures ,Disease Models, Animal ,Fractures, Ununited ,Orthopedic surgery ,biology.protein ,Female ,Rabbits ,business ,Nuclear medicine ,Bone Plates - Abstract
Long-bone segmental defects caused by infection, fracture, or tumour are a challenge for orthopaedic surgeons. Structural allografts are sometimes used in their treatment but their poor biological characteristics are a liability. The objective of this study was to determine whether the addition of recombinant vascular endothelial growth factor-A (VEGF) to a structural allograft improved its integration into a rabbit tibial segmental defect in a non-union model. Tibial segmental defects were filled with heat sterilized allogenic tubular tibiae sections and then stabilized with a screw plate. In the VEGF treatment group (n = 6 tibiae), 2 μg of VEGF added to a 50 μl matrigel solution was inserted into the allograft cavity. In the control group (n = 6 tibiae), only matrigel was added. After 12 weeks, macroscopic and microscopic analysis, radiographs, and computerized micro-tomography (micro-CT) were performed. If allograft consolidation was present, a torsional resistance analysis was performed. Addition of VEGF to the allograft decreased the rate of osteosynthesis failure compared with the control group (1/6 vs. 5/6, p = 0.08), increased trabecular continuity evaluated by micro-CT in the bone–allograft interphases (8/12 vs. 2/12, p = 0.036) and histological trabecular continuity (7/12 vs. 0/12, p = 0.0046). Full consolidation was observed in three tibiae of the VEGF group and one in the control group (differences not significant); however, torsional resistance showed no significant differences (n.s.). Addition of VEGF to a structural allograph inserted into a rabbit tibial segmental defect increased allograft integration rate. Further research in this direction might help clinicians in dealing with large bone defects.
- Published
- 2013