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Bisphosphonate Delivery to Tubular Bone Allografts

  • Symposium: New Approaches to Allograft Transplantation
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Large structural allografts used for reconstruction of bone defects after revision arthroplasty and tumor resection fracture up to 27% of the time from osteolytic resorption around the fixation screw holes and tendon or ligament attachment sites. Treating structural allografts before implantation with bisphosphonates may inhibit local osteoclastic processes and prevent bone resorption and the development of stress risers, thereby reducing the long-term fracture rate. Taking advantage of allografts’ open-pore structure, we asked whether passive soaking or positive-pressure pumping was a more efficient technique for delivering bisphosphonates. We treated matched pairs of ovine tibial allografts with fluids containing Tc-99m pamidronate and toluidine blue stain to facilitate indicator distribution analysis via microSPECT-microCT imaging and light microscopy, respectively. Surfactants octylphenoxy polyethoxy ethanol or beractant were added to the treatment fluids to reduce flow resistance of solutions pumped through the allografts. Indicator distribution after 1 hour of soaking produced a thin ring around periosteal and endosteal surfaces, while pumping for 10 minutes produced a more even distribution throughout the allograft. Flow resistance was reduced with octylphenoxy polyethoxy ethanol but unaffected with beractant. Pumped allografts displayed a more homogeneous indicator distribution in less time than soaking while surfactants enhanced fluid movement.

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Acknowledgments

We thank Abbott Laboratories for donating the beractant (Survanta®), and Colorado State University College of Veterinary Medicine for donating the ovine sheep tibia.

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Authors and Affiliations

  1. Department of Surgery/Orthopaedic Surgical Service, Memorial Sloan-Kettering Cancer Center, Weill Medical College of Cornell University, 1275 York Ave., Suite A342, New York, NY, 10065-6004, USA

    Gene R. DiResta PhD, Mark W. Manoso MD, Anwar Naqvi MS, Wakenda Tyler MD, Carol Morris MD & John H. Healey MD

  2. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, Weill Medical College of Cornell University, New York, NY, USA

    Pat Zanzonico PhD

  3. Department of Radiology, Memorial Sloan-Kettering Cancer Center, Weill Medical College of Cornell University, New York, NY, USA

    Peter Smith-Jones PhD

Authors
  1. Gene R. DiResta PhD
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  2. Mark W. Manoso MD
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  3. Anwar Naqvi MS
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  4. Pat Zanzonico PhD
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  5. Peter Smith-Jones PhD
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  6. Wakenda Tyler MD
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  7. Carol Morris MD
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  8. John H. Healey MD
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Corresponding author

Correspondence to Gene R. DiResta PhD.

Additional information

One or more of the authors (CM, JHH) has received funding from the Orthopaedic Research and Education Foundation; the Musculoskeletal Transplant Foundation; and the Biomet Oncology Fellowship. We acknowledge technical services provided by the MSKCC Small-Animal Imaging Core Facility, supported in part by NIH Small Animal Imaging Research Program (SAIRP) grant #R24 CA83084 and NIH Center Grant #P30 CA 08748.

Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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DiResta, G.R., Manoso, M.W., Naqvi, A. et al. Bisphosphonate Delivery to Tubular Bone Allografts. Clin Orthop Relat Res 466, 1871–1879 (2008). https://doi.org/10.1007/s11999-008-0259-7

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  • DOI: https://doi.org/10.1007/s11999-008-0259-7

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