A small team of researchers from Cleveland’s Case Western Reserve University have put together a package that encases material that is identical to the ingredients that allow bone to re-grow and heal where there are injuries. The package is placed where bone needs to heal. The package is used as a storage and delivery tool for the nature-alike material to the fractures. (1)
It has been observed that following this method of delivery heals serious bone injuries faster than any of the current methods used worldwide. The new technique also helps heal bone wounds that have no chance of healing if left to it’s own devices and such injuries where bone re-growth is expected to be very slow.
As per Melissa Knothe Tate, a joint professor of biomedical engineering and mechanical & aerospace engineering at Case Western Reserve University, “We’re trying to use the methods Mother Nature uses to generate bone.” The team whose report was published in the December 2011 issue of PLoS ONE also had Ulf Knothe, an orthopedic surgeon at the Cleveland Clinic, as well as Hana Chang and Shannon Moore, graduate students in Knothe Tate’s lab. The technical report of the finding may be had at the PLoS ONE link given below. (2)
The ‘implant device’ utilises an FDA-approved elastic material (used for surgeries) that apes bones’ own sheath-like cover called periosteum. Periosteum is essentially a membrane that lines the outer surface of most bones in our body. This periosteum has an outer fibrous layer in which are embedded fibroblasts or cells that make connective tissues. The inner layer of the periosteum known as the cambium layer contain in them progenitor cells that develop into osteoblasts and chondroblasts which in turn help create bone and aid the healing process. (3)
The device has been tested out on sheep in Switzerland and on a limited number of clinical cases involving humans with amazing success. The elastic wrapping used in the device to deliver the nature-like material to the injured bones delivered stem cells, growth factors and other natural components of the periosteum that give the right cues for bone regeneration.
When the experiments were run, the best case outcomes scenarios indicated the dense re-growth and network of new bone filling out the fracture or injury beautifully. The filling occurred from the surgical elastic wrapping on the outside towards the steel intra-medullary nail that stabilized the bone on the inside, bridging old with new bone.
Knothe made the periosteum-like sheath by stitching together two sheets of FDA-approved elastic. On one sheet she made perforations across the center of the sheet while the other was left intact. The sutures used for stitching the sheets also served to ‘create’ open pockets through which movement of cells and bone building materials upward, downwards and inwards was possible. One such ‘device’ was filled with collagen; another ‘device’ was filled with collagen containing fibroblasts and chondroblasts. A third ‘device’ was filled with periosteum strips. In sheep, pockets filled with natural periosteal strips, though no longer connected to blood supply, provided the ingredients for the bone to grow bone quickly, densely, and completely. Such device also offers a template for new bone growth. (4)
The new storage and delivery device can be used for many more foreseeable purposes such as for growing cartilage, for fusing vertebrae and as a delivery system for stem cells and antibiotics.