Integration of heterologous bone matrix associated with polymethylmethacrylate in induced tibial bone defects. An experimental study in rabbits

To analyze and compare the reactions at the interface between the composite, composed of fragmented heterologous mineralized bone matrix (MOMHF) and polymethylmethacrylate (PMMA), and the rabbit’s tibias, through macroscopic evaluation and scanning electron microscopy (SEM) in different periods.

Methods

In this study, 12 New Zealand adult rabbits were used (E1: n = 3, E2: n = 3, E3: n = 3 and E4: n = 3). They had the right tibial defects filled with composite and were evaluated immediately after surgery and at 30, 60, 90, and 120 days.

Results

The composites were incorporated and integrated into the recipient beds in 100% of the cases, defined by the MOMHF osseointegration and the PMMA fibrointegration, with no sign of infection, migration, or rejection.

Conclusions

The behavior of the composites in the recipient beds demonstrates that these biomaterials have the potential to be used in bone defect repairs, offering, thus, better quality of life to the orthopedic patient.

Key words
Bone-Implant Interface; Polymethylmethacrylate; Bone Matrix; Bone Cements; Osseointegration; Tibia; Rabbits

Authorship

Silvio Henrique De Freitas *Corresponding author: silviohfreitas@usp.br | (55 19)3565-6881

MSc, PhD, Associate Professor. Veterinary Medicine Department (ZMV) - Faculty of Animal Sciences and Food Engineering (FZEA) – Universidade de São Paulo (USP) – Pirassununga (SP), Brazil.Universidade de São PauloBrazilPirassununga, SP, BrazilMSc, PhD, Associate Professor. Veterinary Medicine Department (ZMV) - Faculty of Animal Sciences and Food Engineering (FZEA) – Universidade de São Paulo (USP) – Pirassununga (SP), Brazil.

https://orcid.org/0000-0001-7595-0367

Alois Foltran Müller

Fellow PhD degree. Postgraduate Program in Animal Bioscience (PPBA), Faculty of Animal Sciences and Food Engineering (FZEA) – Universidade de São Paulo (USP) – Pirassununga (SP), Brazil.Universidade de São PauloBrazilPirassununga, SP, BrazilFellow PhD degree. Postgraduate Program in Animal Bioscience (PPBA), Faculty of Animal Sciences and Food Engineering (FZEA) – Universidade de São Paulo (USP) – Pirassununga (SP), Brazil.

https://orcid.org/0000-0002-4053-9161

Thaís Ribeiro Fadel

Fellow Master degree. Postgraduate Program in Animal Bioscience (PPBA), Faculty of Animal Sciences and Food Engineering (FZEA) – Universidade de São Paulo (USP) – Pirassununga (SP), Brazil.Universidade de São PauloBrazilPirassununga, SP, BrazilFellow Master degree. Postgraduate Program in Animal Bioscience (PPBA), Faculty of Animal Sciences and Food Engineering (FZEA) – Universidade de São Paulo (USP) – Pirassununga (SP), Brazil.

https://orcid.org/0000-0002-9332-8026

Wellington Henrique Bessi

https://orcid.org/0000-0002-6968-870X

Renata Gebara Sampaio Dória

https://orcid.org/0000-0002-4275-0358

Kelly Cristiane Ito Yamauchi

MSc, PhD. Department of Veterinary Clinic and Surgery - Faculty of Veterinary Medicine – Cuiaba (MT), Brazil.Faculty of Veterinary MedicineBrazilCuiaba, MT, BrazilMSc, PhD. Department of Veterinary Clinic and Surgery - Faculty of Veterinary Medicine – Cuiaba (MT), Brazil.

https://orcid.org/0000-0001-8200-3341

Ricardo De Francisco Strefezzi

https://orcid.org/0000-0002-8810-2815

Atanásio Serafim Vidane

MSc, PhD. Department of Clinics - Faculty of Veterinary Medicine - Eduardo Mondlane University - Maputo, Mozambique.Eduardo Mondlane UniversityMozambiqueMaputo, MozambiqueMSc, PhD. Department of Clinics - Faculty of Veterinary Medicine - Eduardo Mondlane University - Maputo, Mozambique.

https://orcid.org/0000-0001-7634-4975

Carlos Alberto Fortulan

MSc, PhD, Associate Professor. Department of Mechanical Engineering – Universidade de São Paulo (USP), Sao Carlos (SP), Brazil.Universidade de São PauloBrazilSao Carlos, SP, BrazilMSc, PhD, Associate Professor. Department of Mechanical Engineering – Universidade de São Paulo (USP), Sao Carlos (SP), Brazil.

https://orcid.org/0000-0002-2259-9910

Carlos Eduardo Ambrósio

https://orcid.org/0000-0002-8224-5022

*Corresponding author: silviohfreitas@usp.br | (55 19)3565-6881

Conflict of interest: Nothing to declare.

Author’s contribution

Intellectual and scientific content of the study: Ambrósio CA and Bessi WH; Design the study: Fortulan CA; Conception and design the study: De Freitas SH; Acquisition of data: Dória RGS and Strefezzi RF; Acquisition and analysis of data: De Freitas SH; Interpretation of data: Müller AF and Fadel TR; Technical procedures: De Freitas SH and Vidane AS; Manuscript preparation: Müller AF, Fadel TR, Yamauchi KCI and Strefezzi RF; Manuscript writing: De Freitas SH; Critical revision: Fadel TR, Fortulan CA and Ambrósio CA; Supervised all phases of the study: Dória RGS; Final approval: Fortulan CA and Ambrósio CA.

SCIMAGO INSTITUTIONS RANKINGS

Figures | Tables

Figures (5)
Tables (1)

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Figure 1
Electromicrographs, obtained by SEM, of the composite in the rabbit’s right tibial recipient bed of the E1 group. (a-f) Cortical bone of the recipient bed and MOMHF, interface between composite and recipient bed (white asterisk), neoformed cortical bone (red asterisk and dotted circle), non-mineralized tissue: fibrous tissue with bundles of fibers (yellow arrow), PMMA and bone fissure (red arrow).

Thumbnail

Figure 2
Electromicrographs, obtained by SEM, of the composite in the rabbit’s right tibia recipient bed of the E2 group. (a-f) Cortical bone of the recipient bed and MOMHF, interface between composite and recipient bed (white asterisk), neoformed cortical bone (dotted red asterisk), integration of MOMHF with recipient bed (yellow asterisk), non-mineralized tissue: fibrous tissue PMMA and bone fissure (red arrow).

Thumbnail

Figure 3
Electromicrographs, obtained by SEM, of the composite in the rabbit’s right tibial recipient bed of the E3 group. (a-f) Cortical bone of the recipient bed and MOMHF, interface between composite and recipient bed (white asterisk), neoformed cortical bone (red asterisk and dotted circle), integration of MOMHF with recipient bed (yellow asterisk), non-mineralized tissue: tissue fibrous fibers (yellow arrow), PMMA and bone fissure (red arrow).

Thumbnail

Figure 4
Electromicrographs, obtained by SEM, of the composite in the rabbit’s right tibial recipient bed of the E4 group. (a-f) Cortical bone of the recipient bed and MOMHF, interface between composite and recipient bed (white asterisk), neoformed cortical bone (red asterisk and dotted circle), integration of MOMHF with recipient bed (yellow asterisk), non-mineralized tissue: fibrous tissue with fibers bundles (yellow arrow), PMMA and bone fissure (red arrow).

Thumbnail

Figure 5
(a, b, c, d) Electromicrographs, obtained by SEM, and EDS line scan (blue line) mapping the chemical elements Ca and P of rabbit’s right tibia recipient bed, neoformed bone tissue (red asterisk) and MOMHF (yellow asterisks) after 30, 60, 90 and 120 days. (e, f, g, h, i, j, k, l) Note Ca and P concentrations on the region of newly formed bone tissue similar to the recipient bed and to the MOMHF (red asterisk).

Thumbnail

Table 1
The composite behavior on rabbit’s tibial recipient bed.

Figure 1 Electromicrographs, obtained by SEM, of the composite in the rabbit’s right tibial recipient bed of the E1 group. (a-f) Cortical bone of the recipient bed and MOMHF, interface between composite and recipient bed (white asterisk), neoformed cortical bone (red asterisk and dotted circle), non-mineralized tissue: fibrous tissue with bundles of fibers (yellow arrow), PMMA and bone fissure (red arrow).

Figure 2 Electromicrographs, obtained by SEM, of the composite in the rabbit’s right tibia recipient bed of the E2 group. (a-f) Cortical bone of the recipient bed and MOMHF, interface between composite and recipient bed (white asterisk), neoformed cortical bone (dotted red asterisk), integration of MOMHF with recipient bed (yellow asterisk), non-mineralized tissue: fibrous tissue PMMA and bone fissure (red arrow).

Figure 3 Electromicrographs, obtained by SEM, of the composite in the rabbit’s right tibial recipient bed of the E3 group. (a-f) Cortical bone of the recipient bed and MOMHF, interface between composite and recipient bed (white asterisk), neoformed cortical bone (red asterisk and dotted circle), integration of MOMHF with recipient bed (yellow asterisk), non-mineralized tissue: tissue fibrous fibers (yellow arrow), PMMA and bone fissure (red arrow).

Figure 4 Electromicrographs, obtained by SEM, of the composite in the rabbit’s right tibial recipient bed of the E4 group. (a-f) Cortical bone of the recipient bed and MOMHF, interface between composite and recipient bed (white asterisk), neoformed cortical bone (red asterisk and dotted circle), integration of MOMHF with recipient bed (yellow asterisk), non-mineralized tissue: fibrous tissue with fibers bundles (yellow arrow), PMMA and bone fissure (red arrow).

Figure 5 (a, b, c, d) Electromicrographs, obtained by SEM, and EDS line scan (blue line) mapping the chemical elements Ca and P of rabbit’s right tibia recipient bed, neoformed bone tissue (red asterisk) and MOMHF (yellow asterisks) after 30, 60, 90 and 120 days. (e, f, g, h, i, j, k, l) Note Ca and P concentrations on the region of newly formed bone tissue similar to the recipient bed and to the MOMHF (red asterisk).

Table 1 The composite behavior on rabbit’s tibial recipient bed.

Groups	Subgroup	Incorporation	Contact with MOMHF	Integration of MOMHF
E1 (30 days)	n.1	+	No	No
	n.2	+	No	No
	n.3	+	No	No
E2 (60 days)	n.1	+	C	I
	n.2	+	C	I
	n.3	+	No	No
E3 (90 days)	n.1	+	C	I
	n.2	+	C	I
	n.3	+	C	I
E4 (120 days)	n.1	+	No	No
	n.2	+	C	I
	n.3	+	C	I

+: incorporation of the composite to the receptor bed; C: contact of MOMHF to the receptor bed; I: integration of the MOMHF to the receptor bed; MOMHF: fragmented heterologous mineralized bone matrix.

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Integration of heterologous bone matrix associated with polymethylmethacrylate in induced tibial bone defects. An experimental study in rabbits

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[1] *Corresponding author: silviohfreitas@usp.br | (55 19)3565-6881