The utilization of a synthetic bone void filler (JAX) in the repair of a femoral segmental  defect

J. R. Field; M. McGee; C. Wildenauer; A. Kurmis; E. Margerrison

doi:10.3415/VCOT-08-02-0019

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2009; 22(02): 87-95
DOI: 10.3415/VCOT-08-02-0019

Original Research

Schattauer GmbH

The utilization of a synthetic bone void filler (JAX) in the repair of a femoral segmental defect

J. R. Field

¹Comparative Orthopaedic Research Surgical Facility (CORe), School of Medicine, Flinders University of South Australia, Australia

,

M. McGee

²Orthopaedics and Trauma, Royal Adelaide Hospital, University of Adelaide, South Australia, Australia

,

C. Wildenauer

²Orthopaedics and Trauma, Royal Adelaide Hospital, University of Adelaide, South Australia, Australia

,

A. Kurmis

¹Comparative Orthopaedic Research Surgical Facility (CORe), School of Medicine, Flinders University of South Australia, Australia

,

E. Margerrison

³Smith and Nephew Orthopaedics, Memphis, Tennessee, USA

› Author Affiliations

Abstract

Summary

Objectives: Currently available synthetic void fillers are indicated for bony voids or gaps that are not intrinsic to the stability of the structure. Jax^™ TCP (tricalcium phosphate) is an osteoconductive bioceramic fabricated into 4 mm granules with a unique interlocking form, promoting structural integrity while allowing bone in-growth. The objective of this study was to assess bone ingrowth using a large, critically sized, femoral defect.

Methods: A 5 cm segmental ostectomy was created in the mid-diaphysis of 16 adult ovine femora. A stainless steel intramedullary nail was introduced and locked with two proximal and two distal fully-threaded locking screws. Each defect was surrounded with a resorbable macroporous poly (L-lactide-co-D, L) lactide mesh acting as graft containment. Treatment groups (n=4) were as follows: 1) Empty defect; 2) Morselized cortical bone; 3) Cortical strut; 4) Jax TCP. Serial radiographs were taken postoperatively and at two, four and six months. Femora retrieved at necropsy (six months) underwent computed tomography for volumetric analysis followed by histological assessment of the biological response.

Results: Little bone was apparent in the empty defect group, whereas significant bone was evident in both autograft groups and the Jax TCP group. Three-dimensional CT reconstructions and volumetric analysis were in close agreement with the radiographic findings.

Clinical significance: Jax TCP bone graft substitute has been proven to be effective in the healing of a large, critically sized, contained segmental defect. The healing observed was superior to that of cortical struts and the new bone laid down had similar radio-opacity to autograft.

Keywords

Segmental defect - void filler - femur - orthopaedic trauma

Full Text

References

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