Category: Surgery

Benn Willcox allograft

Osteoblastic and Stem Cells from Bone Allografts

Osteoblasts are single nucleus cells that synthesize bone, which function in groups of connected cells during the process of bone formation, as individual cells cannot create bone. Successful bone fusion relies on three crucial components: an osteoconductive matrix, an osteoinductive signal, and osteogenic cells.

Today, autograft bone is one of the most commonly used processes for bone grafting, and is often considered the traditional gold standard, containing all three components mentioned above. The Trinity ELITE and the Trinity Evolution allografts are both human donor bone grafts that contain a viable cancellous and a demineralized bone component, which also includes adult human mesenchymal cells and osteoprogenitor cells (MSCs and OPCs). These are retained within the cancellous bone matrix.

In a study conducted by a group of a members from New York University, SRM University in India, Orthofix, Inc., and the Department of Neurosurgery from the Mayo Clinic in Phoenix, Arizona, marker proteins and gene expressions were tested in bone chips. This was done to test their osteogenic and therapeutic abilities. Four different donor batches were tested, which were thawed and homogenized, then centrifuged using an RNA solution. For comparison, cultures of bone marrow cells (BMCs) derived from both human marrow and other Trinity Evolution samples were used.

The RNA isolation techniques implemented yielded great amounts of RNA for the analysis. The subsequent findings showed that the RNAs associated with MSCs and other bone-forming cells flourished at high to intermediate levels in both the Trinity ELITE and Trinity Evolution samples. For almost all of the genes tested, their levels of expression were either similar to or greater than cultures of BMCs.

In conclusion, both the Trinity ELITE and Trinity Evolution proved to have cell populations that exhibit high levels of gene expression with markers associated with MSCs, osteoprogenitors, and other bone-forming cells. Very low levels or no gene expression at all were shown with immunoreactive cells. This indicates that these cells did not flourish within the tissue, suggesting that this allogenic graft is much less likely to trigger an immune response.

These findings suggest that Trinity allografts possess material that contains an active osteogenic component that has the potential of contributing to bone healing in a clinical setting. Yet another finding that proves the efficiency and quality of Trinity products, and their high standards in the world of allografts and cell research.

 
For more on Orthofix products and allograft information in general, visit BennWillcox.net.

Benn Willcox arthrodesis

The Successes of CBA’s in Arthrodesis

Within the next decade, the number of arthrodesis procedures is expected to continue to increase due to aging populations and complex combinations of diseases in individuals. The goals of arthrodesis procedures are to decrease pain, increase mobility, and improve one’s overall quality of life.

Arthrodesis typically focuses on the reversal of disability associated with arthritis, trauma, diabetes, instability, or misalignment in joints, and successful procedures can depend on numerous risk factors. Considerations you should take into account beforehand include levels of tobacco or alcohol abuse, osteoporosis, use of anti-inflammatory drugs, age, and weight.

The quantity of autograft is sometimes limited, and the bone quality can be poor. This is especially common in older patients and those with a combination of physical difficulties. A second surgery may be required to reduce pain and improve mobility in these individuals, though a variety of bone graft substitutes have since been developed. These new developments range from synthetic matrices, to bone marrow aspirates, though, until recently, none of these substitutes consisted of bone-forming cells.

Breaking down cellular bone allografts (CBA’s), they biologically provide three properties that are necessary for proper bone formation. These include osteoconductive scaffolds, osteoinductive growth factors, and osteogenic cells. Orthofix’s Trinity Elite is a cryopreserved CBA that contains at least 500,000 living cells per CC, the donors of which are strictly screened by MTF based on multiple criteria like age and overall health. In the end, less than 3% of donors are accepted, showing how high the standards are for those that wish donate.

In order to measure CBA’s effects in arthrodesis procedures, a clinical trial was performed for 103 patients undergoing foot and/or ankle arthrodesis, of which were enrolled at 10 institutions and at least 18 years of age. The patients varied for their needs to undergo the procedure, ranging from arthritis, to deformities, to degenerative joint disease. 92 of these individuals successfully completed their 6-month follow-ups after the procedures were done, the primary endpoint being successful fusion after this time, following CT scans that confirmed such findings.

 
To simulate real life scenarios, patients considered high-risk were not excluded from the study. The use of CBA’s did not raise any concerns in terms of safety seeing as there were no adverse effects or infections in those that participated either. Statistically significant improvements in pain and function were noted at the end of the study, which notably improved throughout the entire process, thus showing the success CBA’s have in arthrodesis procedures.

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