Effect of human amniotic membrane on the consolidation during bone lengthening by distraction: Experimental study in rabbits.

Abstract

This study aimed to assess the effect of implantation of fresh human amniotic membranes (HAM) on bone consolidation during distraction bone lengthening. Ten New Zealand white rabbits were used in this study. For each rabbit, we performed a diaphyseal tibial osteotomy after installing a single-plane distraction external fixator. Rabbits were divided into 2 groups (n = 5): an osteotomy and rapid lengthening of 2.8 mm/days (negative control (NC) group) or an osteotomy with implantation of fresh HAM and rapid lengthening of 2.8 mm/days (HAM group). We carried out a rapid lengthening at a rate of 2 turns/day for 7 days and a single turn on the 8th day knowing that one turn corresponds to an elongation of 1.4 mm. The total elongation obtained was 21 mm corresponding to 20-25 % of the length of the rabbit's tibia. A radiological study was carried out on 4 and 8 weeks after the end of lengthening. Micro-computed tomography (μ-CT) analysis was carried out 8 weeks after the end of the lengthening and after the sacrifice of the rabbits associated with histological analyses. For the HAM group, radiographic analysis showed that all cases consolidated with a homogeneous callus visible at 1 month after lengthening, and complete corticalization was demonstrated at μ-CT analysis. Histological staining exhibited thick continuous cortices with intramedullary fibro adipose tissue with a medulla rich in hematopoietic cells. The results show that HAM affects the stimulation of bone consolidation during bone lengthening by distraction.