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Regeneration of new bone in revision hip replacements using a tissue engineering technique.

Korda, M.; (2007) Regeneration of new bone in revision hip replacements using a tissue engineering technique. Doctoral thesis , University of London. Green open access

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Abstract

Impaction allografting is used to fill osteolytic defects during revision total hip replacements (rTHR). However clinical results are inconsistent as bone fracture and excessive implant migration are a major complication. Most importantly allograft does not adequately enhance new bone formation. As a consequence the results of rTHR are often inferior to primary THR due to lack of bone stock. Other studies indicate that tissue engineering (TE) using Mesenchymal Stromal Cells (MSCs) seeded onto a resorbable scaffold can regenerate new bone. The overall aim of my thesis was to test the hypothesis that TE of autologous MSCs and MSC derived osteoblast cells incorporated with impaction allografting will significantly enhance new bone formation in revision THRs. The study is divided into in vitro and in vivo phases. In the in vitro phase the technique of osteogenic differentiation and seeding of the autologous ovine MSCs onto allograft was optimised. Previously determined normal impaction forces of 3, 6 and 9kN were used to study the viability of these impacted MSCs and osteogenically seeded cells on the allograft. The results showed that both MSCs and osteoblast cells are affected by the impaction forces. However the MSCs can survive normal impaction forces of 3-6kN while osteoblast cells can only survive impaction forces under 3kN. The in vivo phase was an ovine model used to compare new bone formation between MSCs, osteoblasts and a control group in an orthotopic, ectopic and revision hip. The results show that overall MSCs enhance new bone formation in all the scaffolds compared with the osteoblast and control group. However osteoblast cells do not contribute to new bone formation. The conclusion from the study was that MSCs in conjunction with the impaction allografting technique enhance new bone formation. The tissue engineering technique can be developed into a clinical application in revision THRs where large bone defects have become problematic.

Type: Thesis (Doctoral)
Title: Regeneration of new bone in revision hip replacements using a tissue engineering technique.
Identifier: PQ ETD:592214
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest
UCL classification: UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Engineering Science Faculty Office > Institute of Healthcare Engineering
URI: https://discovery.ucl.ac.uk/id/eprint/1444904
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