Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2020; 87(1):48-51 | DOI: 10.55095/achot2020/007

Minimally Invasive Cancellous Bone Graft Harvesting in Trauma Indication - Experimental Part of the StudyOriginal papers

P. LÁTAL^1,*, Z. ŠTIKOVÁ², Z. TŘÍSKA¹, J. ŠPERL¹, M. KLOUB¹

¹ Oddělení úrazové chirurgie Nemocnice České Budějovice, a.s.

² Patologické oddělení Nemocnice České Budějovice, a.s.

PURPOSE OF THE STUDY:
Our experimental study presents a set of bone grafts harvested by a minimally invasive procedure from selected deceased donors. Our objective was to compare the concentration of red bone marrow in the cancellous bone harvested in this way from selected regions with the reference harvesting from the iliac crest. Thus, the potential of grafts to heal complicated fractures or non-unions is assessed.

MATERIAL AND METHODS:
The Hospital Department of Pathology provided 10 cadaver preparations - 7 male and 3 female for the experiment. In the process of selection, the age limit was 18-50 years, the other exclusion criteria were severe injuries and burning to death as mechanisms affecting the condition of the skeletal system, bone diseases except for osteoporosis, and malignant diseases. From each preparation, a total of 12 samples of cancellous bone tissue were harvested from pre-defined 6 harvest sites bilaterally - proximal humerus, proximal ulna, greater trochanter of proximal femur, distal femur, proximal tibia and from the reference region of the iliac wing. The grafts were harvested using a 10 mm bone cutter. In total, 120 samples of cancellous bone of the determined diameter and uniform length of 30 mm were obtained. The obtained preparations were laboratory processed, fixed, decalcified and hematoxylin-eosin stained. The samples were assessed microscopically. The share of the bone tissue and cancellous bone was expressed as a percentage. Determined as a healing potential parameter was the concentration of red bone marrow and its ratio to the yellow bone marrow was stated. The hypothesis was tested using the ANOVA analysis of variance.

RESULTS:
The highest concentration of red bone marrow was observed in cancellous grafts harvested from the iliac wing with 34.95%, followed by greater trochanter of proximal femur with 31.7%, distal femur with 26.9% and proximal humerus with 21.9%. Its concentration was negligible in proximal tibia with 2.55% and proximal ulna with 0.15%.
By ANOVA statistical method the values of reference samples from the iliac wing and greater trochanter of the femur, distal femur and proximal humerus were compared. The differences are not statistically significant - P 0.60, 0.48 and 0.34 (p < 0.05). No significant differences were found in the concentration of red bone marrow. Statistically compared were also the values of reference samples from the iliac wing and proximal tibia, proximal ulna. This difference is statistically significant - P 0.0008 and 0.0002 (p

Keywords: bone marrow, stem cells, bone healing/orthobiologics, new technology assessment, autograft harvesting

Published: December 1, 2020  Show citation