ArticleFoot & ankle orthopaedics2025
Proteomic and Molecular Analysis of Viable Bone Debris From Foot and Ankle Osteotomies: Implications for Autologous Grafting.
Article in Foot & ankle orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In orthopaedic foot and ankle procedures, bone debris generated during osteotomies is typically discarded. However, this autograft bone debris has good handling properties and can be amenable for use as a stimulus to bone healing at the site of the osteotomy. Methods: In the present study, discarded bone debris was harvested intraoperatively during minimally invasive chevron Akin (MICA) hallux valgus corrections, isolated Akin osteotomies of the proximal phalanx of the great toe, cheilectomies, and calcaneal osteotomies from 9 participants. Results: Multiplex protein arrays of 40 cytokines and 41 growth factors identified 76 immunomodulatory and reparative proteins within the bone debris. Fifteen key growth factors and cytokines (VEGF, PDGF-BB, M-CSF, EGF-R, HGF, ICAM1, GCSF, TIMP-2, sTNFRII, MCP-1, GM-CSF, IL-6sR, IL-10, MCP-2, RANTES) were prominent, suggesting that bone debris proteins may have potential effects on immunomodulation and bone regeneration including cytokine-cytokine receptor interaction, interleukins, MAPK, PI3K-Akt, Wnt, BMP, and TGFβ signaling pathways.Mesenchymal stem/stromal cells (MSCs) were isolated from bone debris of the osteotomies. MSCs expressed genes involved in bone and cartilage formation, homeostasis, angiogenesis, and immunomodulation. Fourteen genes were associated with maintaining cell stemness, whereas seventeen genes were linked to osteochondral development and spatial organization. Additionally, the study identified eight genes promoting angiogenesis and ten genes regulating immune responses in the mesenchymal stem cell environment. Conclusion: This repurposed surgical waste contains a concentrated array of growth factors, antiinflammatory mediators, and viable MSC that might enhance bone healing when reintroduced to surgical sites. Clinical Relevance: The results could serve as a foundation for repurposing previously discarded bone debris as autologous bone grafts for reimplantation in minimally invasive orthopaedic procedures to potentially enhance bone tissue healing. To confirm clinical relevance, further well-controlled trials are required to establish whether these findings improve bone healing rates and related patient-reported outcomes.
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