One of the most challenging problems in osteogenic 3D-tissue engineering is, to quantify the amount of new hydroxylapatite deposition. 18F-NaF-Labeling is a new, high-sensitive method to proof and quantify the osteogenic potential of hMSCs in an in vitro 3D-model.
18F-labeled sodium fluorine was the first widely used agent for skeletal scintigraphy in the 1960s. 18F-NaF is rapidly exchanged for hydroxylgroups of the hydroxylapatite, covalently binding to the surface of new bone, which results in the formation of fluoroapatite. Three dimensional scaffolds are used to favor osteogenic differentiation of precursor cells. Cell-loaded scaffolds are investigated for their healing potential of critical size bone defects. Assessing the osteogenic potential of MSCs in 3D-in vitro cultures is of major interest in tissue engineering in order to maximise bone formation in vitro and in vivo. One of the most challenging problems is, to quantify directly the amount of new hydroxylapatite deposition without destroying the evaluated cell-loaded scaffold. Within this abstract, we present a novel, non-destructive, high-sensitive method to quantify the amount of local hydroxylapatite deposition in 3D-cultures using 18F-NaF.Summary Statement
Introduction
In pre-operative planning for total hip arthroplasty (THA), femoral offset (FO) is frequently underestimated on AP pelvis radiographs as a result of inaccurate patient positioning, imprecise magnification, and radiographic beam divergence. The aim of the present study was to evaluate the reliability and accuracy of predicting three-dimensional (3-D) FO as measured on computed tomography (CT) from measurements performed on standardised AP pelvis radiographs. In a retrospective cohort study, pre-operative AP pelvis radiographs and corresponding CT scans of a consecutive series of 345 patients (345 hips, 146 males, 199 females, mean age 60 (range: 40-79) years, mean body-mass-index 27 (range: 29-57) kg/m2) with primary end-stage hip osteoarthritis were reviewed. Patients were positioned according to a standardised protocol and all images were calibrated. Using validated custom programmes, FO was measured on corresponding AP pelvis radiographs and CT scans. Inter- and intra-observer reliability of the measurement methods were evaluated using intra-class correlation coefficients (ICC). To predict 3-D FO from AP pelvis measurements, the entire cohort was randomly split in two groups and gender specific linear regression equations were derived from a subgroup of 250 patients (group A). The accuracy of the derived prediction equations was subsequently assessed in a second subgroup of 100 patients (group B). In the entire cohort, mean FO was 39.2mm (95%CI: 38.5-40.0mm) on AP pelvis radiographs and 44.6mm (95%CI: 44.0-45.2mm) on CT scans. FO was underestimated by 14% on AP pelvis radiographs compared to CT (5.4mm, 95%CI: 4.8-6.0mm, p<0.001) and both parameters demonstrated a linear correlation (r=0.642, p<0.001). In group B, we observed no significant difference between gender specific predicted FO (males: 48.0mm, 95%CI: 47.1-48.8mm; females: 42.0mm, 95%CI: 41.1-42.8mm) and FO as measured on CT (males: 47.7mm, 95%CI: 46.1-49.4mm, p=0.689; females: 41.6mm, 95%CI: 40.3-43.0mm, p=0.607). The results of the present study suggest that femoral offset can be accurately and reliably predicted from AP pelvis radiographs in patients with primary end-stage hip osteoarthritis. Our findings support the surgeon in pre-operative templating and may improve offset and limb length restoration in THA without the routine performance of CT.
