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This study evaluates the impact of sterilisation or desinfection of bone transplants on their biocompatibility. Therefore a 12 week human bonemarrow cellculture was performed with autologeous and heat treated bone plateletts.
Repair of large skeletal defects using bone allografts has become a routine procedure in orthopaedic and trauma surgery. Different procedures of sterilisation (82.5 degrees C disinfection; 121 degrees C autoclaving; PES; Tutoplast; 25 kGy gamma irradiation) are available to inactivate bacteria and fungi, including their spores, as well as viruses in human bone allografts. The efficiency of these procedures has been proven. However, the effects on the cellular response are rarely investigated. This present in vitro study investigates the immunological answer of human bone marrow cells to human allogenous and autologous bone platelets which were sterilised by different methods.
Human bone marrow cells and the bone platelets were harvested from patients undergoing a total hip replacement. All patients provided informed consent. Human bone platelets, 10 mm in diameter, 3 mm in height, were produced from femoral heads which were removed within the scope of total hip replacements. They were used as autologeous bone transplants or were disinfected (> 82.5 degrees C thermodisinfection). As control a human bone marrow cell culture without bone platelets was used. Over a period of 12 weeks the changes of the interleucins and different enzymes were monitored. Light and scanning microscopy were done to reveal morphological differences. As a vitality test the trypan-blue staining was performed.
After 4 weeks the autologous bone platelets were completely covered with homogenously distributed human osteoblast like cells. The heat-sterilised/disinfected transplants demonstrated similar effects compared to the autologous bone grafts. The heat sterilisation or, respectively, disinfection methods compared to the autologous bone donation demonstrated almost similar in vitro effects. According to the interleucin-values the heat treatment with >82.5°C seems to be a nontoxic method to sterilize bonegrafts.
The results demonstrate the influence of the different sterilisation and disinfection procedures on the differentiation of human marrow cells (host). Similar in vitro effects were seen for the autologous and heat-treated bone platelets.