A manmade package filled with nature's bone-building ingredients delivers the goods over time and space to heal serious bone injuries faster than products currently available, Cleveland researchers have found.
Tested on sheep in Switzerland, the surgical elastic "implant device," essentially a wrapping that mimics bone's own sock-like sheath called periosteum, delivered stem cells, growth factors and other natural components of the periosteum to heal a defect that would not heal on its own if left untreated. In experimental groups exhibiting best outcomes, a dense network of new bone filled the defect, from the surgical elastic wrapping on the outside towards the steel intramedullary nail that stabilized the bone on the inside, bridging old with new bone.
Melissa Knothe Tate, a joint professor of biomedical engineering and mechanical & aerospace engineering at Case Western Reserve University; Ulf Knothe, an orthopedic surgeon at the Cleveland Clinic, as well as Hana Chang and Shannon Moore, graduate students in Knothe Tate's lab, report their work in today's issue of PLoS ONE.
"We're trying to use the methods Mother Nature uses to generate bone," Knothe Tate said.
The device is modeled after the periosteum, the sock-like covering of bone, which is filled with stem cells and growth factors that, given the right cues, grow bone. Knothe Tate and her husband, Knothe, reported last year that bridging a bone injury with periosteum healed bone faster than any currently used methods, in testing on sheep and in limited clinical cases.
But, often there is too little of the periosteal covering left to fully cover the gap after a traumatic injury.
Based on what they'd learned, Knothe Tate built a version of periosteum out of two elastic sheets, approved by the FDA for surgery. She left one intact and perforated the other in a gradient with most holes across the center of the sheet and fewer the farther from the
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Case Western Reserve University