Repair of Critical Calvarias Defects With Systemic Epimedium sagittatum Extract

It is well established in reconstructive surgery the repair of great bone defects is a difficult goal to be achieved. The aim of this study was to evaluate the influence of an extract rich in icariin on bone neoformation in critically sized defects in rat calvaria. Under continual saline irrigation, a circular bone defect was created in 40 rat calvarias with an 8-mm diameter trephine drill. Animals were randomly divided into a test group that received an Epimedium sagittatum extract (containing 5.8 mg/mL of icariin) and a control group that received an equal volume of saline solution. Substances were administered daily through a feeding tube until euthanasia. After 7, 14, 21, and 42 days, 5 animals from each group were euthanized. Calvaria defect samples were fixed in 10% formalin for 48 hours, X-rayed, and histologically processed. In the test group, there was a significant reduction in the bone defect area on X-ray images and an increase in new bone area in all of the experimental periods in the test group. At 42 days, the bone in the test group also exhibited a significant reduction in osteocyte (P = 0.002) and osteoclast density (P = 0.041). The authors conclude that administration of systemic Epimedium extracts containing high concentrations of icariin can induce bone neoformation and reduce osteocyte and osteoclast densities, thereby altering the normal deposition and remodeling patterns that are present in critically sized bone defects.