Bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis: experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defects
Abstract Background Managing large bone defects remains a significant clinical problem. We enhanced the osteogenic activity of the induced membrane (IM) by incorporating bone marrow fluid, leading to spontaneous osteogenesis (SO). We aimed to explore the application of this method in tibiofibular fu...
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BMC
2025-02-01
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| Series: | Journal of Translational Medicine |
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| Online Access: | https://doi.org/10.1186/s12967-024-05840-1 |
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| author | Qudong Yin Xueming Chen Shihao Du Xuming Wei Yongwei Wu Fanyu Bu |
| author_facet | Qudong Yin Xueming Chen Shihao Du Xuming Wei Yongwei Wu Fanyu Bu |
| author_sort | Qudong Yin |
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| description | Abstract Background Managing large bone defects remains a significant clinical problem. We enhanced the osteogenic activity of the induced membrane (IM) by incorporating bone marrow fluid, leading to spontaneous osteogenesis (SO). We aimed to explore the application of this method in tibiofibular fusion (TFF) for reconstructing segmental tibial defects. Methods Forty-two rats with femoral defects were divided into seven groups (n = 6). Defects in groups A1-3 and B1-3 were filled with polymethylmethacrylate spacers while Group B4 was the control. Kirschner wires were used in Groups A1 and B1, plating was used in Groups A3 and B3-4, while the medullary canal was sealed in Groups A2 and B2. In Group A, osteogenic activity was measured using immunohistochemistry, W-B, and qRT-PCR. In Group B, the osteogenic results were measured using X-ray and gross examinations. Ten patients with 4–10 cm segmental defects of the middle and distal tibia underwent reconstruction using the IM technique, and IM and bone marrow fluid-induced SO for TFF, whose effects were assessed. Results At five weeks, Group A1 showed higher levels of BMSCs and expression of BMP-2 and TGF-β1 than Groups A2 and A3 (p < 0.05). After 12 weeks, Group B1 had more new bone at the bone end than Group B3 (p = 0.009) whereas Groups B2 and B4 did not. All tibial defects and TFF healed. The TFF site and posterior tibia healed faster than the other sides and showed quicker clinical healing (p < 0.05). All patients could fully bear weight before tibial clinical healing, with an excellent-to-good functional rate of 80% (Paley’s criterion) at the 13 – to 36-month follow-up. Conclusion Bone marrow fluid enhances the osteogenic activity of IMs leading to SO. TFF by SO progresses faster than tibial clinical healing, making the IM technique an effective stabilizer for faster and better functional recovery after reconstruction of segmental defects of the middle and distal tibia. |
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| institution | OA Journals |
| issn | 1479-5876 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | Journal of Translational Medicine |
| spelling | doaj-art-fa3af3c163204c69a990078cf30ea76c2025-08-20T02:01:39ZengBMCJournal of Translational Medicine1479-58762025-02-0123111410.1186/s12967-024-05840-1Bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis: experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defectsQudong Yin0Xueming Chen1Shihao Du2Xuming Wei3Yongwei Wu4Fanyu Bu5Department of Orthopaedics, Wuxi Ninth People’s Hospital Affiliated to Soochow University, No. 999 Liangxi RoadDepartment of Orthopaedics, Wuxi Ninth People’s Hospital Affiliated to Soochow University, No. 999 Liangxi RoadDepartment of Orthopaedics, Wuxi Ninth People’s Hospital Affiliated to Soochow University, No. 999 Liangxi RoadDepartment of Orthopaedics, Wuxi Xinwu District Xinrui HospitalDepartment of Orthopaedics, Wuxi Ninth People’s Hospital Affiliated to Soochow University, No. 999 Liangxi RoadDepartment of Orthopaedics, Wuxi Ninth People’s Hospital Affiliated to Soochow University, No. 999 Liangxi RoadAbstract Background Managing large bone defects remains a significant clinical problem. We enhanced the osteogenic activity of the induced membrane (IM) by incorporating bone marrow fluid, leading to spontaneous osteogenesis (SO). We aimed to explore the application of this method in tibiofibular fusion (TFF) for reconstructing segmental tibial defects. Methods Forty-two rats with femoral defects were divided into seven groups (n = 6). Defects in groups A1-3 and B1-3 were filled with polymethylmethacrylate spacers while Group B4 was the control. Kirschner wires were used in Groups A1 and B1, plating was used in Groups A3 and B3-4, while the medullary canal was sealed in Groups A2 and B2. In Group A, osteogenic activity was measured using immunohistochemistry, W-B, and qRT-PCR. In Group B, the osteogenic results were measured using X-ray and gross examinations. Ten patients with 4–10 cm segmental defects of the middle and distal tibia underwent reconstruction using the IM technique, and IM and bone marrow fluid-induced SO for TFF, whose effects were assessed. Results At five weeks, Group A1 showed higher levels of BMSCs and expression of BMP-2 and TGF-β1 than Groups A2 and A3 (p < 0.05). After 12 weeks, Group B1 had more new bone at the bone end than Group B3 (p = 0.009) whereas Groups B2 and B4 did not. All tibial defects and TFF healed. The TFF site and posterior tibia healed faster than the other sides and showed quicker clinical healing (p < 0.05). All patients could fully bear weight before tibial clinical healing, with an excellent-to-good functional rate of 80% (Paley’s criterion) at the 13 – to 36-month follow-up. Conclusion Bone marrow fluid enhances the osteogenic activity of IMs leading to SO. TFF by SO progresses faster than tibial clinical healing, making the IM technique an effective stabilizer for faster and better functional recovery after reconstruction of segmental defects of the middle and distal tibia.https://doi.org/10.1186/s12967-024-05840-1Bone defectInduced membraneTibiofibular fusionSpontaneous osteogenesisBone marrow |
| spellingShingle | Qudong Yin Xueming Chen Shihao Du Xuming Wei Yongwei Wu Fanyu Bu Bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis: experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defects Journal of Translational Medicine Bone defect Induced membrane Tibiofibular fusion Spontaneous osteogenesis Bone marrow |
| title | Bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis: experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defects |
| title_full | Bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis: experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defects |
| title_fullStr | Bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis: experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defects |
| title_full_unstemmed | Bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis: experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defects |
| title_short | Bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis: experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defects |
| title_sort | bone marrow fluid enhances the osteogenic activity of induced membrane leading to spontaneous osteogenesis experimental validation and application in tibiofibular fusion for support reconstruction of segmental tibial defects |
| topic | Bone defect Induced membrane Tibiofibular fusion Spontaneous osteogenesis Bone marrow |
| url | https://doi.org/10.1186/s12967-024-05840-1 |
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