REPARATIVE REGENERATION AT THE END OF BONE FILING AFTER OSTOPLASTIC AMPUTATION

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• Bone stump formation after amputation is crucial for prosthetic limb integration.
• Optimizing bone stump healing and structure remains a significant clinical challenge.
• Understanding the biomechanical and biological interactions of bone grafts is essential.

Purpose of the Study:

• To investigate the efficacy of different bone grafting methods in forming bone stumps post-amputation.
• To evaluate the histological and microcirculatory outcomes of various stump closure techniques.
• To identify optimal bone grafting strategies for achieving organotypic bone stump regeneration.

Main Methods:

• Three experimental series involving thigh amputation and stump grafting in 44 rabbits.
• Techniques included hermetic closure with cortical plates, spongy bone, and angled cortical grafts.
• Histological examination with vascular filling assessed outcomes at 1, 3, and 6 months.

Main Results:

• Hermetic closure with cortical plates (Series I) resulted in cylindrical stumps with normalized microcirculation, though graft displacement caused issues.
• Spongy bone closure (Series II) consistently yielded organotypic stumps.
• Incomplete closure (Series III) led to microcirculatory disruption and pathological bone remodeling.

Conclusions:

• Favorable bone stump formation requires a cylindrical shape and compact bone structure.
• Normalization of intraosseous microcirculation is a key indicator of successful healing.
• Hermetic closure techniques, particularly with spongy bone, show promise for organotypic bone stump regeneration.