Background. Living bone allotransplants (ATs) currently require long-term immunosuppression (IS), but this is impractical for extremity-preserving procedures. An alternativemethod to maintain viability of the transplant uses host-derived neoangiogeneic vessels combined with short-term IS.Materials and Methods. Diaphyseal femoral defects in Dutch-Belted rabbits were reconstructed with a free microvascular AT from New Zealand White rabbits. Additionally, a host-derived intramedullary pedicled fascial flap was placed and short-term IS administered to two of four groups. Neovascularization and bone healing were quantified by microangiography and a custom radiographic score.Results. Bone ATs with perfused fascial flaps achieved bone healing equivalent to auto transplant controls, even when they received IS only until host-derived neoangiogenesis replaced the original perfusion. Vascularized ATs without this combination achieved signi-ficantly inferior results.Summary. This rabbit model demonstrated that increased bone turnover allows good healing but may temporarily weaken the allotransplant. However, by the more intense replacement of the graft with host-derived cells, this process may, in the long-term, ultimately result in a better transplant than an avascular graft.
- Allogenic bone
- Microvascular transplantation
- Rabbit model
- Surgical neoangiogenesis
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Emergency Medicine