Specialty: Orthopaedic Surgery

Keywords: Orthopaedic Implants, Limb Reconstruction, Vascularized Bone Graft

Background: This study aims to evaluate the potential of native vascularized bone grafts to facilitate soft tissue attachment to nonbiologic metal implants. This approach targets complex reconstructive scenarios involving large resections of bone and soft tissue that have been lost due to trauma, degenerative disease, or oncologic procedures.

Objective: We seek to assess long-term survival and integration of vascularized bone grafts with soft tissue attachments while also evaluating the interface between graft and titanium implant in terms of mechanical strength and biological incorporation.

Methods: A rabbit hind limb amputation model will be used. Following distal femoral amputation, a titanium endoprosthetic implant will be fixed to the residual limb, and two autologous bone grafts — one vascularized and one non-vascularized — will be harvested and attached to the implant. Native tendon will then be secured to the grafts. Animals will undergo post-operative imaging to monitor graft incorporation. At study endpoint, animals will be euthanized, and the integrity of the graft-soft tissue and graft-implant interfaces will be analyzed using gross pathology, histology, and mechanical failure testing.

Results: This is an ongoing study. Expected outcomes include demonstrable survival of the vascularized bone grafts, sustained tendon-bone integration, and secure graft-implant fixation. Mechanical testing will quantify the strength of the tendon-graft and graft-implant interfaces, while histology will evaluate tissue viability and interface morphology.

Conclusions: This investigation introduces a novel strategy for enhancing soft tissue attachment to nonbiologic implants using vascularized bone grafts. If successful, the technique may revolutionize treatment paradigms for large-scale bone and joint reconstructions by restoring stability, improving function, and reducing the risk of limb loss due to soft tissue failure. Moreover, using a vascularized bone graft eliminates the need for direct continuity with native bone, opening the door to innovative prosthesis designs that are capable of prioritizing function and biological integration over anatomic constraints.