Effectiveness of tissue engineered based three dimensional porous gelapin-simvastatin bioactive graft on bone healing and regeneration: a multiphasic in vivo study with high value in translational medicine
Authors: Ali Moshiri 1 , Mostafa Shahrezaie 1 , Babak Shekarchi 2 , Ahmad Oryan 3 , Kamran Azma 4
1) Department of Orthopedic Surgery and Research, School of Medicine, AJA University of Medical Science,
Tehran, Iran
2) Department of Radiology, School of Medicine, AJA University of Medical Science, Tehran, Iran
3) Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
4) Department of Rehabilitation, School of Medicine, AJA University of Medical Science, Tehran, Iran

Criteria
Score Bone
0 union
Complete bone union
1
2
3
4
Bone filling
Complete filling. Entire the defect area is filled with new tissue
Partial bone union
More than 75% of the defect area is filled with new tissue
Non union Between 25 to
50% of the defect area is filled with new tissue
Less than 25% of the defect area is filled with new tissue
No tissue filled the defect area
Cortical rim formation
Cortex and medulla are diagnostic so that two distinct opacity can be seen in the defect area which is comparable to the intact parts of the radial bone
Cortex and medulla are formed but it is hard to distinguish their opacity from each other
Cortex and medulla has not been differentiated as yet
Defect alignment
The regenerated tissue filling the defect area is regenerated along the anatomic direction of the bone
The regenerated tissue filling the defect area is regenerated along the anatomic direction of the bone but has partially invaded outside the defect area
The regenerated tissue filling the defect area is not regenerated along the anatomic direction of the bone and completely invaded outside the defect area
Callus quality
Hard callus is completely formed
More than 50% of the regenerated tissue is hard callus
Between 25 to 50% of the regenerated tissue is hard callus
Between 1 to 25% of the regenerated tissue is hard callus
All the regenerated tissue is soft callus
5 No callus is formed
Callus homogeneity Radial bone malformation
Callus is homogenously formed so that its cortical rim and medulla have distinct but homogenous opacity.
Radial bone shows normal anatomic appearance and the bone edges are in accordance to each other.
Callus is homogenously formed but the cortex and medulla have not been differentiated as yet.
Distal part of the radial bone shows slight transposition but the two bony ends are still in one anatomic line
Callus shows partial homogeneity
Callus shows no homogeneity
Distal part of the radial bone shows moderate transposition and the two bony ends are not seen along the anatomic line direction
Distal part of the radial bone shows severe transposition and the two bony ends are not seen along the anatomic line direction
Distal and proximal parts of the radial bone show moderate to severe transposition and the two bony ends are not seen along the anatomic line direction
Distal part of the radial bone shows moderate transposition and the two bony ends are not seen along the anatomic line direction. In addition, the ulnar shape is changed. Bone shows severe bowing.