[Recombinant growth hormone accelerates regenerate consolidation in distraction osteosynthesis]. / Rekombinantes Wachstumshormon beschleunigt die Regeneratkonsolidierung bei der Distraktionsosteogenese.

Distraction osteogenesis is a good model for evaluation of fracture healing with intramembranous bone formation. The purpose of the present study was to investigate whether homologous GH has a stimulating effect on bone healing in distraction osteogenesis. The left tibiae of 30 micropigs were osteomized and distracted with an external fixator 2 mm daily over a period of 10 days. Animals were killed after an additional healing time of 10 days. The treatment group received 100 micrograms r-pGH per kg bodyweight per day. A newly developed device allowed non-destructive torsional biomechanical evaluation of the regenerate strength as in vivo measurements. After killing, destructive torsional strength testing of the sites of distraction was performed. To determine the endocrine response to the administration of r-pGH, serum levels of IGF-I were determined. The non-destructive in vivo testing showed that torsional stiffness of the regenerate was significantly higher in the treatment group than in the control group. Final regenerate torsional failure load was 131% higher and ultimate torsional stiffness was 231% higher in the treatment group than in the control group. The mean serum level of IGF-I increased to 440% of the preoperative base level in the treatment group and remained unchanged in the control group. Our data indicate that systemic administration of recombinant homologous growth hormone significantly accelerates ossification of bone regenerate in distraction osteogenesis.

The influence of screw geometry on hamstring tendon interference fit fixation.

We used a standardized model of calf tibial bone to investigate the influence of screw diameter and length on interference fit fixation of a three-stranded semitendinosus tendon graft for anterior cruciate ligament reconstruction. Biodegradable poly-(L-lactide) interference screws with a diameter of 7, 8, and 9 mm and a length of 23 and 28 mm were used. We examined results in three groups of 10 specimens each: group 1, screw diameter equaled graft diameter and screw length was 23 mm; group 2, screw diameter equaled graft diameter plus 1 mm and screw length was 23 mm; group 3, screw diameter equaled graft diameter and screw length was 28 mm. The mean pull-out forces in groups 1, 2, and 3 were 367.2+/-78 N, 479.1+/-111.1 N, and 537.4+/-139.1 N, respectively. The force data from groups 2 and 3 were significantly higher than those from group 1. These results indicate that screw geometry has a significant influence on hamstring tendon interference fit fixation. Increasing screw length improves fixation strength more than oversizing the screw diameter. This is important, especially for increasing tibial fixation strength because the tibial graft fixation site has been considered to be the weak link of such a reconstruction.

Recombinant growth hormone accelerates bone regenerate consolidation in distraction osteogenesis.

The purpose of the present study was to prove whether homologous GH has a stimulating effect on bone healing. Therefore, left tibiae of 30 micropigs were osteomized and distracted over an external fixator at the rate of 2 mm/day on each of 10 consecutive days. Animals were killed after a healing period of another 10 days. The treatment group received 100 microg of recombinant porcine growth hormone (rpGH) per kilogram of body weight per day. Serial torsional nondestructive biomechanical tests were performed in vivo using a newly developed measurement device. After killing, destructive torsional strength testing of the sites of distraction was performed. To determine the endocrine response to the administration of rpGH, serum levels of insulin-like growth factor-I (IGF-I) were determined. Nondestructive in vivo testing showed that torsional stiffness of the regenerate was significantly higher in the treatment group than in the control group. Final regenerate torsional failure load was 131% higher and ultimate torsional stiffness was 231% higher in the treatment group than in the control group. The mean serum level of IGF-I increased to 440% of preoperative basal level in the treatment group and remained unchanged in the control group. Our data indicate that systemic administration of recombinant homologous growth hormone greatly accelerates ossification of bone regenerate in distraction osteogenesis.

[Recombinant growth hormone increasus callus maturation time in distraction osteogenesis--a histomorphometric study]. / Rekombinantes Wachstumshormon beschleunigt die Kallusreifung bei der Distraktionsosteogenese--Eine histomorphometrische Untersuchung.

Purpose of the present study was, to proof whether homologous recombinant GH has an stimulating effect on bone healing in distraction osteogenesis. Therefore the left tibiae of 20 micropigs were osteotomized and distracted over an external fixator 2 mm daily on each of ten consecutive days. Animals were sacrificed after a healing time of another ten days. The treatment group received 100 micrograms r-pGH per kg bodyweight per day. After sacrifice, the regenerates were embedded undecalcified and cut into 6 microns thick sagittal oriented slices. Callus area, bone area, cartilagee area and bone perimeter in the regenerates were measured using an image analysis system. The results revealed, that GH promotes bone formation and maturation of the regenerate without disturbing the callus structure.