Evaluation of Osteoinductive and Osteoconductive Effect of the Amniotic Membrane in Bone Defects due to Open Fractures in Rabbits

Abstract

Background: The repair of long bone segmental defects is one of the most challenging problems in orthopaedic surgery.
Objectives: The current researchers carried out animal experiments on the use of Human Amniotic Membrane (HAM) in bone defect to evaluate the osteoinductive and osteoconductive effects, and also to use it as a guide for regular production of bone without waiting for membrane production (MASQUELET method).
Methods: Twenty New Zealand white male adult rabbits were used in the study, and divided to four groups. The surgical site was prepared with the purpose of working on the left forearm diaphysis. In each radius, a bone defect of 15-mm in length was created. The fixation of the radius was not done because the support of the ulna was sufficient. The defect was not filled with anything in group 1; however, a tube-shaped HAM was inserted in group 2, a Tendon-shaped HAM was utilized for group 3 and a Tube-shaped HAM + bone graft (demineralized bone matrix, DBM) was used in group 4.
Results: Bone formation was radiographically observed in the defects, which had been implanted using tube-shaped HAM (group 2), which was complete in 60% and partially complete in 40% of the cases. No bone formation was seen at up to eight weeks after surgery in group 1 and 3. A small amount of bone formation was observed at both ends and the ulnar site of the defect in group 4.
Conclusions: The results of the study indicated that tube-shaped HAM could have an osteoconductive effect in large segmental bone defects, yet could not have an osteoinductive effect.