In vivo evaluation of deer antler trabecular bone as a reconstruction material for bone defects

Availability of graft materials to fill up osseous defects has always been a concern in orthopaedic surgeries. Deer antler material is a primary bone structure that is easy to collect and could serve as a xenograft. This study examines the behaviour of red deer antler trabecular cylinders in critical size distal femoral epiphyseal defects in 11 rabbits, and evaluates the effect of the decellularization protocols. Two preparation regimes (A and B) were used, with and without lipids and proteins. Radiographs were taken immediately after surgery and after euthanasia 12 weeks post-implantation. Histological evaluation was performed on non-decalcified 10-μm sections with a van Gieson picro-fuchsin staining protocol. A region of interest was defined for each histological section, evaluating the inflammatory reaction, the fibrosis process, and the osteogenesis. Each histological section was microradiographed to evaluate bone contact, presence of synostosis, remodelling and ossification processes. All antler cylinders were successfully implanted. Final radiographic analysis demonstrated osteointegration of most implants at various stages. Light to moderate inflammation around the grafts was noted with only one case showing full encapsulation. A variable degree of intimacy between implant and host bone was evidenced, with bone remodelling and osteogenesis of various intensity being present in all implanted sites. No differences were found between group A and B. Removal of lipids and proteins in the grafts surprisingly did not seem to matter. Decellularization and sterilization protocols may be advocated. Although it presents several limitations, this study shows some promising results regarding antler trabecular bone osteointegration.