The BMP-2 content and bone forming potential of 2 leading allograft products (OsteoAMP® and Osteocel® Plus) was tested across 3 commercially available lots. Surprisingly, there was no BMP-2 content associated with the cells contained within Osteocel® Plus. OsteoAMP® contained greater than 1000 times the overall BMP-2 content than Osteocel® Plus. Correspondingly, Osteocel® Plus did not form new bone at any timepoint in the 12 week in vivo study while OsteoAMP® had increasing new bone formation at each sequential timepoint. Interestingly, the highest cellularity of Osteocel® Plus was just prior to implant at t0, decreasing at each timepoint, decreasing further at the terminal endpoint of the study at 12 weeks (82% of cells had died or migrated). Conversely, the cellularity of OsteoAMP® increased at each timepoint. Implants containing living cells are often characterised by the orthobiologics industry as ‘osteogenic’. The positive function and ultimate fate of these cells has been assumed with little to no proof of efficacy. In this study we compare the bone forming ability of the market leading stem cell product claiming osteoinductivity as well as osteogenicity, Osteocel® Plus, against the market leading allograft derived growth factor product, OsteoAMP® which claims osteoinductivity but contains no viable cells. The goal of the study is to determine if a cellular product will form new bone or produce a false positive when evaluated histomorphometrically using an osteoinductive control over time in vivo. Additionally, the osteoinductive potential from each product will be quantified by in vitro by measurement of BMP-2 content via ELISA.Summary
Introduction
Intramedullary nail fixation has been used for successful treatment of long bone fracture such as humerus, tibia and femur. We look at the experience of our trauma unit in treating long bone fracture using the AO approved Expert femoral/tibial nail and proximal femoral nail antirotation (PFNA). We look at the union and complication rates in patients treated with AO approved nailing system for pertrochanteric, femoral and tibial shaft fracture. We carried out retrospective case notes review of patients that underwent femoral and tibial nailing during the period of study- October 2007 to August 2009. All patients were treated using the AO approved nailing system. We identified all trauma patients that underwent femoral and tibial nailing through the trauma register. Further information was then obtained by going through medical notes and reviewing all followed-up X-rays stored within the online radiology system.INTRODUCTION
METHODS
