Qualitative and Quantitative Assessment of the Regenerate Bone Formed During Intramedullary Limb Lengthening Using a Goat (Caprine) Tibia Model: A Pilot Study

Introduction: With the increasing popularity of intramedullary limb lengthening, it has been observed that the regenerate bone formed during this process appears visually different from the regenerate bone formed during extramedullary limb lengthening using external fixators. Using a goat tibia mode...

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Main Authors: Anirejuoritse Bafor, Aidan Isler, Kell Sprangel, Sara McBride-Gagyi, Christopher A. Iobst
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Journal of Limb Lengthening & Reconstruction
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Online Access:https://journals.lww.com/10.4103/jllr.jllr_16_24
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Summary:Introduction: With the increasing popularity of intramedullary limb lengthening, it has been observed that the regenerate bone formed during this process appears visually different from the regenerate bone formed during extramedullary limb lengthening using external fixators. Using a goat tibia model, this pilot study is the first to evaluate the regenerate bone formed from intramedullary limb lengthening comprehensively. Materials and Methods: After a magnetically driven internal lengthening nail was inserted, a 2 cm lengthening of the goat tibia was performed. The regenerate bone formation was assessed using plain radiographs and micro-computed tomography (CT). An analysis of the regenerate bone mineralization was also measured using micro-CT. Histology of the regenerate bone using hematoxylin and eosin staining provided additional descriptive analysis. Results: Regenerate bone appeared as early as the 2nd–4th week of distraction and progressed from the periphery to the center as well as from the bone ends toward the center of the regenerate, delineating a distinct fibrous interzone and a previously undescribed “inner zone.” Bone formation and maturation were fastest on the posterior cortex. Histology showed evidence of both intramembranous and endochondral ossification. Conclusions: Our findings outline the pattern of bone formation during intramedullary lengthening. In addition, the discovery of a previously unreported fibrous “inner zone” is described.
ISSN:2455-3719