Application of a novel bone osteotomy plate leads to reduction in heat-induced bone tissue necrosis in sheep

Bekić, Marijo and Davila, Slavko and Hrskanović, Mato and Bekić, Marijana and Seiwerth, Sven and Erdeljić, Viktorija and Capak, Darko and Butković, Vladimir (2008) Application of a novel bone osteotomy plate leads to reduction in heat-induced bone tissue necrosis in sheep. Collegium Antropologicum, 32 (4). pp. 1229-1237. ISSN 0350-6134

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Abstract

Previous studies have shown substantial effect thermal damage can have on new bone formation following osteotomy. In this study we evaluated the extent of thermal damage which occurs in four different methods of osteotomy and the effects it can have on bone healing. We further wanted to test whether a special osteotomy plate we constructed can lead to diminished heat generation during osteotomy and enhanced bone healing. The four methods evaluated included osteotomy performed by chisel, a newly constructed osteotomy plate, Gigly and oscillating saw. Twelve adult sheep underwent osteotomy performed on both tibiae. Bone fragments were stabilized using a fixation plate. Callus size was assessed using standard radiographs. Densitometry and histological evaluation were performed at 8 weeks following osteotomy. Temperature measurements were performed both in vivo during the operation, and ex vivo on explanted tibiae. The defects healed without complications and showed typical course of secondary fracture healing with callus ingrowth into the osteotomy gap. Radiographic examination of bone healing showed a tendency towards more callus formation in bones osteotomized using Gigly and oscillating saw, but this difference lacked significance. Use of Gigly and oscillating saw elicited much higher temperatures at the bone cortex surface, which subsequently lead to slightly impaired bone healing according to histological analysis. BMD was equal among all bones. In conclusion, the time required for complete healing of the defect differed depended greatly on the instruments used. The newly constructed osteotomy plate showed best results based on histological findings of capillary and osteoblast density.

Abstract in Croatian

Iz dostupne literature jasno je vidljiv negativan učinak topline na formiranje novog koštanog tkiva nakon osteotomije. Naše istraživanje je ispitivalo različiti stupanj toplinskog oštećenja kosti primjenom četiri različite tehnike osteotomije. Svrha nam je bila pokazati smanjuje li novokonstruirana pločica za osteotomiju toplinsko oštećenje, čime poboljšava cijeljenje kosti. Vrste instrumenata za osteotomiju koje smo istraživali su bili dlijeto, novokonstruirana pločica za osteotomiju, Giglijeva i oscilacijska pila. Kod dvanaest zrelih ovaca smo osteotomirali obje stražnje tibije. Primjenom pločice za osteosintezu smo fiksirali koštane ulomke. Stvaranje kalusa smo pratili na kontrolnim RTG slikama. Osam tjedana poslije osteotomije učinili smo denzitometrijsko i histološku obradu osteotomiranih kosti. Temperaturu koja se oslobađa pri osteotomiji smo mjerili in vivo za vrijeme zahvata te in vitro na izoliranim kostima. Koštani defekti su cijelili bez komplikacija uz karakterističnu sliku sekundarnog cijeljenja kosti uz urastanje kalusa u osteotomijsku pukotinu. Radiološko istraživanje koštanog cijeljenja je pokazalo pojačano stvaranje kalusa u kostima osteotomiranim Giglijevom i oscilacijskom pilom, ali ova različitost nije bila statistički značajna. Giglijeva i oscilacijska pila oslobađaju znatno veću količinu topline na površini kosti, što rezultira oslabljenim koštanim cijeljenjem što smo pokazali histološkim istraživanjem. Sve kosti su imale sličnu mineralnu gustoću. Zaključno, vrijeme potrebno za kompletno cijeljenje koštanog defekta u velikoj mjeri ovisi o instrumentu koji koristimo u svrhu osteotomije. Na temelju histološkog mjerenja gustoće osteoblasta i kapilara, novokonstruirana pločica je pokazala najuspješnije cijeljenje uz minimalno termičko i biomehaničko oštećenje kosti.

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