ArticleThe Journal of bone and joint surgery. American volume2016
Reverse Dynamization: Influence of Fixator Stiffness on the Mode and Efficiency of Large-Bone-Defect Healing at Different Doses of rhBMP-2.
Article in The Journal of bone and joint surgery. American volume, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed.
- Revisiting bone healing strategies: the potential of reverse dynamization in veterinary orthopedics.Frontiers in veterinary science · 2026Review
- Article
- Article
- Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review.Bioengineering (Basel, Switzerland) · 2024Review
- Biomechanics of fracture healing: how best to optimize your construct in the OR.OTA international : the open access journal of orthopaedic trauma · 2024Article
- Great debates in trauma biomechanics.OTA international : the open access journal of orthopaedic trauma · 2023Review
- Bone fracture healing: perspectives according to molecular basis.Journal of bone and mineral metabolism · 2021Review
- Application of subject-specific adaptive mechanical loading for bone healing in a mouse tail vertebral defect.Scientific reports · 2021Article
- Combinatorial morphogenetic and mechanical cues to mimic bone development for defect repair.Science advances · 2019Article
- Recapitulating bone development through engineered mesenchymal condensations and mechanical cues for tissue regeneration.Science translational medicine · 2019Article
- Regenerative rehabilitation: The role of mechanotransduction in orthopaedic regenerative medicine.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2019Review
- Image Analysis Software as a Strategy to Improve the Radiographic Determination of Fracture Healing.Journal of orthopaedic trauma · 2018Article
- The Interaction of BMP2-Induced Defect Healing in Rat and Fixator Stiffness Modulates Matrix Alignment and Contraction.JBMR plus · 2018Article
- Restoration of bone defects using modified heterogeneous deproteinized bone seeded with bone marrow mesenchymal stem cells.American journal of translational research · 2017Article
- A Concert between Biology and Biomechanics: The Influence of the Mechanical Environment on Bone Healing.Frontiers in physiology · 2016Review
- Strain-Dependent Effects of Controlled Micromotion on Fracture Healing: Rethinking the Strain Threshold.JB & JS open accessArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReverse dynamization is a technology for enhancing the healing of osseous defects. With use of an external fixator, the axial stiffness across the defect is initially set low and subsequently increased. The purpose of the study described in this paper was to explore the efficacy of reverse dynamization under different conditions.
methodsRat femoral defects were stabilized with external fixators that allowed the stiffness to be modulated on living animals. Recombinant human bone morphogenetic protein-2 (rhBMP-2) was implanted into the defects on a collagen sponge. Following a dose-response experiment, 5.5 μg of rhBMP-2 was placed into the defect under conditions of very low (25.4-N/mm), low (114-N/mm), medium (185-N/mm), or high (254-N/mm) stiffness. Reverse dynamization was evaluated with 2 different starting stiffnesses: low (114 N/mm) and very low (25.4 N/mm). In both cases, high stiffness (254 N/mm) was imposed after 2 weeks. Healing was assessed with radiographs, micro-computed tomography (μCT), histological analysis, and mechanical testing.
resultsIn the absence of dynamization, the medium-stiffness fixators provided the best healing. Reverse dynamization starting with very low stiffness was detrimental to healing. However, with low initial stiffness, reverse dynamization considerably improved healing with minimal residual cartilage, enhanced cortication, increased mechanical strength, and smaller callus. Histological analysis suggested that, in all cases, healing provoked by rhBMP-2 occurred by endochondral ossification.
conclusionsThese data confirm the potential utility of reverse dynamization as a way of improving bone healing but indicate that the stiffness parameters need to be selected carefully. CLINICAL RELEVANCE: Reverse dynamization may reduce the amount of rhBMP-2 needed to induce healing of recalcitrant osseous lesions, reduce the time to union, and decrease the need for prolonged external fixation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.