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Study finds demineralized bone matrix potentially helpful in implant fixation

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Canadian researchers have found demineralized bone matrix to have osteoinductive capacity in orthotopic bone sites, meaning it could potentially be of use for enhancing implant fixation in revision arthroplasty.

The findings were presented by Letitia Lim, MD, at the 2011 combined Specialty Day of The Hip Society and American Association of Hip and Knee Surgeons.

“There is an array of bone graft substitutes available on the market,” Lim said. “The focus of this study is demineralized bone matrix because it is relatively inexpensive, has good handling characteristics, and has proven to be quite conductive and osteoinductive.”

In the study, Lim and her colleagues sought to demonstrate the osteoinductive properties of demineralized bone matrix, as well as ascertain the timeframe and extent of promoted gap healing around — and bone ingrowth within — porous implants.

Study parameters and findings

The group inserted porous titanium implants into the proximal metaphyses of canine femora and humeri, leaving a gap of 3 mm between the implant and the host cacellous bone. These gaps were then either left empty (control), filled with demineralized bone matrix, or filled with devitalized demineralized bone matrix (negative control). These samples were then left in situ for spans of 4 weeks and 12 weeks.

Six gaps of each type were studied at each time period, and volume healing of the gap with the new bone was quantified with 3-D microCT scanning. Bone apposition and ingrowth were quantified through backscattered scanning electron microscopy.

Lim said the density of the bones inside gaps filled with demineralized bone matrix was found to reach 64% and 93% of the surrounding bone density by 4 weeks and 12 weeks, respectively. The gap healing found in the demineralized bone matrix was reportedly two to three times greater at 4 weeks and 12 weeks than that of the control and negative control, with bone apposition and ingrowth two to six times greater.

“[Demineralized bone matrix] shows rapid and large amounts of gap healing with respect to control,” Lim said. “It also shows much more ingrowth and apposition, even at the earliest observed time points. It shows great potential for implant fixation in revision arthroplasty.”

Reference:

• Lim L, et al. Demineralized bone matrix around porous implants promotes rapid gap healing and bone ingrowth. Presented at the 2011 combined Specialty Day of The Hip Society and American Association of Hip and Knee Surgeons. Feb. 19. San Diego.
• Disclosure: No relevant financial disclosure was reported.

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