Effect of extracorporeal irradiation on segmental bone autograft incorporation in Sprague-Dawley rats
Abstract
Background: Bone graft has been widely used in bone tumor reconstructive surgery. Extracorporeal irradiation (ECI) is commonly used to eliminate malignant cells before bone autograft. However, it may have negative effects on autograft incorporation. This study aimed to evaluate the ability of bone autograft incorporation after extra corporeal irradiation.
Methods: 24 Sprague-Dawley rats underwent 7-mm en bloc resection of tibial diaphysis, and were divided into 4 groups. The first group did not receive irradiation; the 2nd, 3rd, and 4th groups received 50, 150 and 300 Gy bone irradiation respectively, and then reimplanted. Radiologic score were evaluated at week-6 and -8, while histopathology, osteoblast count and BMP-2 expression were examined at week-8. Data were analyzed with ANOVA or Kruskal-Wallis tests.
Results: At week-6, radiologic scores in group 150 and 300 Gy were significantly lower compared to control group (4 vs 6 dan 4 vs 6; p = 0.011; p = 0.01). The same results were also obtained at week-8 (5.40 vs 7.14; p = 0.009 in the group 150 Gy and 5.60 vs 7.14; p = 0.018 in the group 300 Gy. Histopathological scores of the groups receiving 50, 150 and 300 Gy were significantly lower compared to the control group (6 vs 7, p = 0.017; 4 vs 7, p = 0.005; 6 vs 7, p = 0.013). Osteoblast count and BMP-2 expression were not significantly different among all groups.
Conclusion: ECI with the dose of 50 to 300 Gy is associated with delayed bone autograft incorporation. However, the osteoinductive and osteogenesis capacity for autograft incorporation were maintained.
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References
El-Wahidi GF, Eldesoky I, Kotb S, Awad I, Thabet M, Thaleh Y. Neoadjuvant chemotherapy & low dose extracorporeal irradiation for treatment of osteosarcoma. J Clin Oncol. 2005;23(16S):9074.
DiCaprio MR, Friedlaender GE. Malignant bone tumors: limb sparing versus amputation. J Am Acad Orthop Surg. 2003;11(1):25-37.
Yusof N. Interaction of radiation with tissues. Singapore: World scientific; 2007. p. 99-107.
Currey JD, Foreman J, Laketić I, Mitchell J, Pegg DE, Reilly GC. Effect of ionizing radiation on mechanical properties of human bone. J Orthop Res. 1997;15(1):111-7. http://dx.doi.org/10.1002/jor.1100150116
Pekkarinen T, Hietala O, Jämsä T, Jalovaara P. Effect of gamma irradiation on the osteoinductivity of morphogenetic protein extract from reindeer bone. Acta Orthop. 2005;76(2):231-6. http://dx.doi.org/10.1080/00016470510030625
Voggenreiter G, Ascherl R, Blümel G, Schmit-Neuerburg KP. Extracorporeal irradiation and incorporation of bone graft. Acta Orthop Scand. 1996;67(6):583-8. http://dx.doi.org/10.3109/17453679608997761
Wang FS, Yang KD, Kuo YR, Wang CJ, Sheen-Chen SM, Huang HC, et al. Temporal and spatial expression of bone morphogenic protein in extracorporeal shock wave promoted healing of segmental defect. Bone. 2003;32(4): 387-96. http://dx.doi.org/10.1016/S8756-3282(03)00029-2
Rauch F, Lauzier D, Croteau S, Travers R, Glorieux FH, Hamdy R. Temporal and spatial expression of bone morphogenetic protein-2, -4, and -7 during distraction osteogenesis in rabbits. Bone. 2000;27(3):453-9. http://dx.doi.org/10.1016/S8756-3282(00)00337-9
Oztürk A, Yetkin H, Memis L, Cila E, Bolukbasi S, Gemalmaz C. Demineralized bone matrix and hydroxyapatite/ tri-calcium phosphate mixture for bone healing in rat. Int Orthop. 2006;30(3):147-52. http://dx.doi.org/10.1007/s00264-006-0079-x
Watanabe Y, Nishizawa Y, Takenaka N, Kobayashi M, Matsushita T. Ability and limitation of radiographic assessment of fracture healing in rats. Clin Orthop Relat Res. 2009;467(8):1981-5. http://dx.doi.org/10.1007/s11999-009-0753-6
Khan SN, Cammisa FP Jr, Sandhu HS, Diwan AD, Girardi FP, Lane JM. The biology of bone grafting. J Am Acad Orthop Surg. 2005;13(1):77-86.
Dimitriou R, Tsiridis E, Giannoudis PV. Current concepts of molecular aspects of bone healing. Injury. 2005;36(12):1392-404. http://dx.doi.org/10.1016/j.injury.2005.07.019
Sugimoto M, Takahashi S, Toguchida J, Kotoura Y, Shibamoto Y, Yamamuro T. Changes in bone afer high doses irradiation. J Bone Joint Surg Br. 1991;73(3):492-7.
Furtsman LL. Effect of radiation on bone. J Dent Res. 1972;51(2):596-604. http://dx.doi.org/10.1177/00220345720510025901
Maeda M, Bryant MH, Yamagata M, Gi L, Earle JD, Chao EY. Effects of irradiation on cortical bone and their time-related changes. A biomechanical and histomorphological study. J Bone Joint Surg Am. 1988;70(3):392-9.
Salter RB. Normal structure and function of musculoskeletal tissues. In: Textbook of disorders and injuries of the musculoskeletal systems. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 1999. p. 7-16.
Jacobsson M, Kälebo P, Tjellström A, Turesson I. Bone cell viability after irradiation. Bone cell viability after irradiation. An enzyme histochemical study. Acta Oncol. 1987;26(6):463-5. http://dx.doi.org/10.3109/02841868709113719
Dare A, Hachisu R, Yamaguchi A, Yokose S, Yoshiki S, Okano T. Effects of ionizing radiation on proliferation and differentiation of osteoblast-like cells. J Dent Res. 1997;76(2):658-64. http://dx.doi.org/10.1177/00220345970760020601
Welch RD, Jones AL, Bucholz RW, Reinert CM, Tjia JS, Pierce WA, et al. Effect of recombinant human bone morphogenetic protein-2 on fracture healing in a goat tibial fracture model. J Bone Miner Res. 1998;13(9):1483-90. http://dx.doi.org/10.1359/jbmr.1998.13.9.1483
Bostrom MP, Lane JM, Berberian WS, Missri AA, Tomin E, Weiland A, et al. Immunolocalization and expression of bone morphogenic proteins 2 and 4 in fracture healing. J Orthop Res. 1995;13(3):357-67. http://dx.doi.org/10.1002/jor.1100130309
Anderson HC, Hodges PT, Aguilera XM, Missana L, Moylan PE. Bone morphogenetic protein (BMP) localization in developing human and rat growth plate, metaphysis, epiphysis, and articular cartilage. J Histochem Cytochem. 2000;48(11):1493-502. http://dx.doi.org/10.1177/002215540004801106
Wientroub S, Reddi AH. Influence of irradiation on the osteoinductive potential of demineralized bone matrix. Calcif Tissue Int. 1988;42(4):255-60. http://dx.doi.org/10.1007/BF02553752
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