Institutional members access full text with Ovid®

Share this article on:

Return of Motor Function After Segmental Nerve Loss in a Rat Model: Comparison of Autogenous Nerve Graft, Collagen Conduit, and Processed Allograft (AxoGen)

Giusti, Guilherme MD; Willems, Wouter F. MD; Kremer, Thomas MD; Friedrich, Patricia F. AAS; Bishop, Allen T. MD; Shin, Alexander Y. MD

Journal of Bone & Joint Surgery - American Volume: 7 March 2012 - Volume 94 - Issue 5 - p 410–417
doi: 10.2106/JBJS.K.00253
Scientific Articles
Supplementary Content

Background: An effective alternative to nerve autograft is needed to minimize morbidity and solve limited-availability issues. We hypothesized that the use of processed allografts and collagen conduits would allow recovery of motor function that is equivalent to that seen after the use of autografts.

Methods: Sixty-five Lewis rats were divided into three experimental groups. In each group, a unilateral 10-mm sciatic nerve defect was repaired with nerve autograft, allograft treated by AxoGen Laboratories, or a 2.0-mm-inner-diameter collagen conduit. The animals were studied at twelve and sixteen weeks postoperatively. Evaluation included bilateral measurement of the tibialis anterior muscle force and muscle weight, electrophysiology, assessment of ankle contracture, and peroneal nerve histomorphometry. Muscle force was measured with use of our previously described and validated method. Results were expressed as a percentage of the values on the contralateral side. Two-way analysis of variance (ANOVA) corrected by the Ryan-Einot-Gabriel-Welsch multiple range test was used for statistical investigation (α = 0.05).

Results: At twelve weeks, the mean muscle force (and standard deviation), as compared with that on the contralateral (control) side, was 45.2% ± 15.0% in the autograft group, 43.4% ± 18.0% in the allograft group, and 7.0% ± 9.2% in the collagen group. After sixteen weeks, the recovered muscle force was 65.5% ± 14.1% in the autograft group, 36.3% ± 15.7% in the allograft group, and 12.1% ± 16.0% in the collagen group. Autograft was statistically superior to allograft and the collagen conduit at sixteen weeks with regard to all parameters except histomorphometric characteristics (p < 0.05). The collagen-group results were inferior. All autograft-group outcomes improved from twelve to sixteen weeks, with the increase in muscle force being significant.

Conclusions: The use of autograft resulted in better motor recovery than did the use of allograft or a collagen conduit for a short nerve gap in rats. A longer evaluation time of sixteen weeks after segmental nerve injuries in rats would be beneficial as more substantial muscle recovery was seen at that time.

Clinical Relevance: On the basis of this study, the enthusiasm for use of processed allograft nerve grafts in motor nerve reconstruction should be tempered until additional studies are performed.

1Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail address for A.Y. Shin:shin.alexander@mayo.edu

Copyright 2012 by The Journal of Bone and Joint Surgery, Incorporated
You currently do not have access to this article

To access this article: