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Cortical and Cancellous Bone Regeneration in Cranioplasty and Spinal Arthrodesis Models Using Autologous Homologous Bone Construct (AHBC)

Pratima Labroo*, Nicholas Baetz, Marytheresa Ifediba, Kendall Stauffer, Michael Sieverts, Jessie Johnson, Eric Chan, Ian Robinson, James Miess, Jennifer Irvin, Lyssa Lambert, Caroline Garrett, Edward W. Swanson, and Nikolai A. Sopko  

Autologous bone grafts are commonly used to treat large bone defects. Though autologous bone grafts have high rates of success, they are limited by availability of donor tissue and may not be suitable for all treatment pathologies. Allografts are an attractive alternative as they do not utilize tissue from the patient but have a higher risk of infection and graft failure. In this study, an autologous homologous bone construct (AHBC) derived from viable bone, was compared to autologous bone grafts and demineralized bone matrix in rabbit models of critical-sized cranial defects and spinal fusion. AHBC is made from a small bone harvest obtained from an uninjured area of the patient. Without any exogenous supplementation or culturing, the AHBC is expeditiously deployed to the treatment site, where it initiates osteogenesis and osteoinduction and closes the defect from the inside out with cortico-cancellous bone. Treated defects were assessed using imaging modalities (micro CT, confocal, SEM, multiphoton, Raman spectroscopy), molecular and proteomics analysis, as well as mechanical testing. AHBC performed as well as autograft in all modalities and exceeded autograft in several. Both AHBC and autograft were observed to have more positive outcomes than DBM+BMP2 in both cranioplasty and arthrodesis models. Clinical significance: AHBC was able to regenerate cortical and cancellous bone in cranioplasty and spinal arthrodesis translational models and is a viable alternative to autografts and allografts.