Abstract
Autogenous cancellous bone has great new bone formation capacity and has been applied to the treatment of nonunion, bone defect and bone tumor. However, donor site morbidity and limitation of graft material have been major incentives to seek of a replacement for autogenous bone grafts and recently new substitutes have been researched in many fields. Bone marrow stromal cell and endosteal cell have been identified as having the capacity to produce new bone. Fibrin glue has good tissue adhesive capacity, helping the ingrowth of fibroblast and neovascularization and supplying stable fibrin network to enhance initial stage of wound healing. The author tried to compare the healing capacity of autogenous bone marrow that had been fixed by autogenous fibrin glue to those of crushed autogenous cortical bone, autogenous bone marrow and autogenous fibrin glue respectively in the ulnar diaphyseal bone defect model of a rabbit. Fifty-six New Zealand White strain rabbits were equally divided into four groups. One and half centimeter block of diaphysis and periosteum of both ulnae were removed. The crushed cortical bone which had been removed from the ulnar diaphysis was reimplanted into the defect of right side for group 1, autogenous fibrin glue for group 2, autogenous bone marrow for group 3 and autogenous bone marrow fixed by autogenous fibrin glue for group 4 and autogenous serum to left ulnar defect of all groups as a control. The average number of implanted viable nucleated cells of these bone marrow was 2.4 X 10(6)/kg. For radiographic evaluation, roentgenograms of both ulnae of 5 rabbits from each group were taken and were evaluated according to the scoring system of Lane and Sandhu. For histological evaluation, histological sections of right ulnae were made and stained with hematoxylin-eosin to fix the first appearance of cartilage, osteoid, cancellous bone, corticalization and bone marrow at first, third, sixth and tenth week. For biomechanical evaluation, five rabbits from each group were sacrificed at the third and tenth week and were tested by the torsional load testing technique to get 4 parameters;maximum torque, maximum angle, stiffness, and absorption energy from both ulnae. Radiographically, the new bone formation of group 4 was better than that of group 2 at the first week. Histologically, first appearance of cancellous bone in group 4 occurred earlier than in the other groups. Biomechanically, maximum torque and absorption energy of right ulna of all groups had significantly high values over the left side indicating enhanced bony healing. The maximum torque of group 2 and 4 were higher than that of group 1 at the third week, and the absorption energy of group 2, 3, and 4 were higher than that of gorup 1, and, finally, the absorption energy of group 4 was higher than those of group 2 and 3 at the third week. In conclusion, autogenous crushed cortical bone, autogenous fibrin glue, autogenous bone marrow and autogenous bone marrow fixed by autogenous fibrin glue showed bone formation capacity, with the last one especially enhancing the initial stage of bony healing.