The effects of the Ilizarov distraction technique on bone and muscle in a canine model: a preliminary report

Abstract

This study examined the functional and morphological changes experienced by bone and muscle during Ilizarov distraction osteogenesis. Although extensive research has been conducted in the area of regenerate bone formation, the effect of limb lengthening on the biomechanical properties of bone and muscle has not been thoroughly addressed. In this study, an Ilizarov external fixator was applied to one tibia of nine skeletally mature dogs, and distracted 3 cm over thirty days. The contralateral tibia served as control. Histology and weekly radiographs assessed muscle morphology and bone growth. The contractile capabilities of the gastrocnemius muscles from the experimental and control limbs were measured prior to sacrifice, and the bending stiffness of the tibias of five dogs was determined. All dogs experienced loss of knee extension secondary to muscle contracture and/or stiffness about the joint. These dogs did not bear weight on the experimental limb. In one dog, spontaneous resolution of the muscle contracture allowed partial weight bearing during the last three weeks of consolidation. Despite 3 cm distraction, tibial lengthening ranged from 1.7 to 3 cm. Biomechanical testing revealed a significant reduction in the bending stiffness of the lengthened bones when compared with control values (p < 0.003). The weight of the lengthened muscles was 35% less than control values, a finding consistent with the histology which showed mild muscle fiber degeneration in all dogs. The contractile capabilities of the lengthened muscles were reduced to 29-80% of control values (p < 0.005). In contrast, the lengthened muscle from the weight bearing dog retained 85% of the weight and 104% of the maximum contractile force of the control muscle.