Publication: Bone allograft non-union is related to excessive osteoclastic bone resorption: A sheep model study
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Date
2006
Authors
Laird, R.K. ; Pavlos, N.J. ; Xu, J. ; Brankov, B. ; White, B. ; Fan, Y. ; Papadimitriou, J.M. ; Wood, D.J. ; Zheng, M.H.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Using a sheep femoral allograft model we
have investigated the cellular and molecular mechanisms
associated with non-union of bone allografts.
Histomorphometric analysis revealed that allograft nonunions
featured both marked increases in osteoclast
(OC) numbers and total eroded bone surface as
compared to allografts wich had undergone direct union.
Three distinct cellular layers lying adjacent to the
allograft bone surface were identified in all non-union
cases. The outer or fibroblastic layer contained an
abundance of fibroblasts and connective tissue.
Circumscribing this layer was a band of synovial-like
cells consisting mainly of large spindle-shaped
mononuclear cells mixed with scattered round-shaped
mononuclear cells. The third layer, which was directly
juxtaposed to the allograft bone surface, consisted
predominantly of multinuclear OCs which were
positively identified by calcitonin receptor
immunohistochemistry. Interestingly, in-situ
hybridisation revealed that surrounding synovial-like
cells in non-union allografts, expressed abundant gene
transcripts for receptor activator NF-kB ligand
(RANKL), a membrane bound factor critical for both the
induction of OC activity and osteoclastogenesis. We
propose that excessive bone resorption by host OCs
contributes, at least partially, to the failure of bone
allografts. The production of RANKL by synovial-like fibroblasts may be the driving force responsible for the
elevated generation and activation of OCs. Based on
such evidence novel therapeutic strategies for the
treatment of non-union bone allografts using anti-bone
resorbing agents may be devised.
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