Repair of calvarial defects with flap tissue

Role of bone morphogenetic proteins and competent responding tissues

Roger K. Khouri, David M. Brown, Basem Koudsi, E. Gene Deune, Louis A. Gilula, Brian C. Cooley, A Hari Reddi

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Bone morphogenetic proteins 2 through 8 have the ability to induce the in vivo transformation of extraskeletal mesenchymal tissue into hone. The aims of this investigation were to determine the optimal responding tissue and the specificity of the inductive effect of bone morphogenetic protein 3. The optimal responding tissue was found to be skeletal muscle. The specificity of this response to hone morphogenetic protein 3 was compared with that of recombinant human basis fibroblast growth factor, recombinant platelet-derived growth factor, and recombinant insulin-like growth factor. Bone morphogenetic protein 3 was the only factor that induced de novo bone formation. This ability to transform muscle into bone was tested in 7 x 7 mm irradiated skull defects in the rat. After 1500 tads of exposure, these defects showed no significant signs of healing by 8 months. When these defects were treated with the microvascular transfer of a nonirradiated muscle flap, they had 8 percent healing at 4 months and 37 percent healing by 8 months. Defects treated with 30 μg bone morphogenetic protein 3 (without the muscle flap) achieved 50 percent healing by 4 months and 64 percent healing by 8 months. When the detects were treated with both the muscle flap and bone morphogenetic protein 3, there was 96 percent healing by 4 months and 100 percent healing by 8 months (p < 0.015, compared with bone morphogenetic protein 3 alone at both time points). At 8 months, the transplanted muscle was entirely transformed into bone and healed the skull defect with newly generated bone indistinguishable from the surrounding calvarial tissue. These findings suggest a potential clinical utility of bone morphogenetic protein 3-induced bone formation in skeletal reconstructions. Furthermore, they also show that there is a collaborative requirement for both the osteoinductive factor bone morphogenetic protein 3 and the presence of competent responsive cells in the well-perfused muscle.

Original languageEnglish (US)
Pages (from-to)103-109
Number of pages7
JournalPlastic and Reconstructive Surgery
Volume98
Issue number1
DOIs
StatePublished - Jul 1996
Externally publishedYes

Fingerprint

Bone Morphogenetic Protein 3
Bone Morphogenetic Proteins
Muscles
Osteogenesis
Skull
Bone and Bones
Bone Morphogenetic Protein 2
Organ Specificity
Fibroblast Growth Factors
Platelet-Derived Growth Factor
Somatomedins
Skeletal Muscle

ASJC Scopus subject areas

  • Surgery

Cite this

Repair of calvarial defects with flap tissue : Role of bone morphogenetic proteins and competent responding tissues. / Khouri, Roger K.; Brown, David M.; Koudsi, Basem; Deune, E. Gene; Gilula, Louis A.; Cooley, Brian C.; Reddi, A Hari.

In: Plastic and Reconstructive Surgery, Vol. 98, No. 1, 07.1996, p. 103-109.

Research output: Contribution to journalArticle

Khouri, Roger K. ; Brown, David M. ; Koudsi, Basem ; Deune, E. Gene ; Gilula, Louis A. ; Cooley, Brian C. ; Reddi, A Hari. / Repair of calvarial defects with flap tissue : Role of bone morphogenetic proteins and competent responding tissues. In: Plastic and Reconstructive Surgery. 1996 ; Vol. 98, No. 1. pp. 103-109.
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