Abstract
The reconstruction of critical size bone defects is still clinically challenging. Even though the transplantation of autologous bone is used as gold standard, this therapy is accompanied by donor site morbidities as well as tissue limitations. The alternatively used allografts, which are devitalized due to thermal, chemical or physical processing, often lose their matrix integrity and have diminished biomechanical properties. High Hydrostatic Pressure (HHP) may represent a gentle alternative to already existing methods since HHP treated human osteoblasts undergo cell death and HHP treated bone cylinders maintain their mechanical properties. The aim of this study was to determine the biological effects caused by HHP treatment regarding protein/matrix integrity and type of cell death in trabecular bone cylinders. Therefore, different pressure protocols (250 and 300 MPa for 10, 20 and 30 min) and end point analysis such as quantification of DNA-fragmentation, gene expression, SDS-PAGE, FESEM analysis and histological staining were performed. While both protein and matrix integrity was preserved, molecular biological methods showed an apoptotic differentiation of cell death for lower pressures and shorter applications (250 MPa for 10 and 20 min) and necrotic differentiation for higher pressures and longer applications (300 MPa for 30 min). This study serves as a basis for further investigation as it shows that HHP successfully devitalizes trabecular bone cylinders.
Highlights
Bone is one of the few human tissues which can regenerate and repair itself (Oryan et al, 2014)
Autologous material is still used as the gold standard due to its advantageous bone-building properties
field emission scanning electron microscopy (FESEM) analysis showed no apparent damage to the ECM after High Hydrostatic Pressure (HHP)-treatment
Summary
Bone is one of the few human tissues which can regenerate and repair itself (Oryan et al, 2014). If the maximum critical defect size is exceeded e.g., due to tumor or trauma, selfregeneration is no longer possible (Nauth et al, 2018). In these cases, bone substitutes which should initiate and support osseous healing must be provided (Beaman et al, 2006). Since autologous bone combines all the above-mentioned positive aspects, it is still the gold standard used in reconstruction surgery (Sohn and Oh, 2019). Another important positive feature is the reduced risk of an immune response
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