Although treating Kienböck disease is controversial, we previously applied a new method
that was less invasive and comprised drilling, bone marrow (BM) transplantation, external
fixation, and radiating low-intensity pulsed ultrasound. We reported good clinical
results obtained by this new method, which were comparable to those obtained using
other, rather invasive methods. Here, we investigated the effect of drilling holes
and transplanting BM into necrotic bone in an animal model to further understand the
effect of these methods on the revitalization of necrotic bone.
We used rabbit fourth tarsal bones, whose surfaces consist of cartilage and cortical
bone, mimicking human lunate bone. We soaked the retrieved bones in liquid nitrogen
to induce necrosis. After thawing, we inserted them separately into bilateral subcutaneous
pouches in the backs of rabbits. A total of 60 rabbits were divided into four groups
of 15 rabbits each: BM transplantation (BM group); peripheral blood transplantation
(PB group); drilling (D group); control (C group). We sacrificed three rabbits to
obtain six specimens in each group at 2, 4, 8, 12, and 20 weeks after operation and
evaluated the specimens histomorphologically.
In the BM group, significantly larger mineralizing surfaces, osteoblast surfaces,
and osteoclast numbers were observed at 4, 8, and 12 weeks compared with those in
the other groups. No significant differences were observed at 2 and 20 weeks in the
groups except the mineralizing surface of the 20-week-BM group, which was significantly
greater.
We examined the efficacy of drilling and of BM transplantation for regenerating necrotic
bone in a rabbit model. Our experiments suggest that drilling with BM transplantation
to the necrotic bone accelerates bone formation and remodeling.