J Korean Orthop Assoc.  2010 Feb;45(1):52-58. 10.4055/jkoa.2010.45.1.52.

Comparison of Processed Nerve Allograft and Laminin Derived Peptide Incorporated Nerve Conduit for Peripheral Nerve Regeneration

Affiliations
  • 1Department of Orthopedic Surgery, St. Vincent Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 2Research Institute of Medical Science, St. Vincent Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 3Department of Oral Biochemistry, School of Dentistry, Seoul National University, Seoul, Korea.
  • 4Department of Polymer Science and Engineering, Sungkyunkwan University, Suwon, Korea. djchung@skku.edu

Abstract

PURPOSE
To compare a processed nerve allograft, laminin derived peptide incorporated nerve conduit, and autograft in terms of electrodiagnostic testing and nerve histomorphometry for peripheral nerve regeneration in a rabbit sciatic nerve defect model.
MATERIALS AND METHODS
Thirty New Zealand white rabbits were divided into three groups, and a unilateral 15 mm sciatic nerve defect was made. Group I, II and III was repaired with a reversed autograft, a processed acellular nerve allograft, and a laminin derived peptide incorporated nerve conduit, respectively. At twelve weeks, the animals were evaluated with the compound muscle action potential, wet muscle weight, and nerve histomorphometric parameters such as nerve area, number of axons, and myelin thickness.
RESULTS
At twelve weeks, the compound muscle action potential for group I, II and III was 54.1%, 38.2% and 26.4%, respectively. Significant differences were found between the three groups (p<0.001, group I vs II; p<0.001, group I vs III; p<0.001, group II vs III). The wet muscle weight for group I, II and III was 57.8%, 54.4% and 43.9%, respectively. Group I had significantly more muscle weight than group III (p<0.001), but the difference was not significant with group II (p=0.256). Group II and III showed a significant difference (p=0.002). The number of axons in group III decreased and the shape of the axon was irregular, even though the nerve area and myelin thickness were similar in the three groups.
CONCLUSION
An autograft remains the gold standard to repair a segmental nerve defect. Processed allograft demonstrated superior nerve recovery compared to the laminin derived peptide incorporated nerve conduit.

Keyword

peripheral nerve regeneration; processed nerve allograft; nerve conduit

MeSH Terms

Action Potentials
Animals
Axons
Laminin
Muscles
Myelin Sheath
Peripheral Nerves
Rabbits
Regeneration
Sciatic Nerve
Transplantation, Homologous
Laminin

Figure

  • Figure 1 Comparison of autograft (A) and processed allograft (H & E stain, × 200). Cells are removed but intact laminin architectures are still preserved in processed allograft (B).

  • Figure 2 Electron micrograph of processed allograft showing preserved intact laminin structures (black arrows, ×10,000).

  • Figure 3 Compound muscle action potentials of the tibialis anterior for the three groups at twelve weeks. Error bars represent 95% confidence intervals. Asterisks represent significant difference between the 2 groups (p<0.05).

  • Figure 4 Wet muscle weight of the tibialis anterior for the three groups at twelve weeks. Error bars represent 95% confidence intervals. Asterisks represent significant difference between the 2 groups (p<0.05).

  • Figure 5 Histologic findings of the cross section of the midgraft in three groups (×4000). Autograft group (A) has more myelinated fibers than allograft (B) and conduit group (C). Regenerated nerve fibers are irregular and interstitial structures are rare in conduit group (C) than autograft group (A) and allograft group (B).


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