{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T18:59:46Z","timestamp":1770145186043,"version":"3.49.0"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["1R01AR078311"],"award-info":[{"award-number":["1R01AR078311"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Avascular necrosis (AVN) involves ischemic cell death of the bone. AVN leaves an abundance of necrotic lipids and debris in the bone marrow, which instigates inflammatory bone repair. Consequently, the necrotic bone microenvironment stimulates excessive bone resorption, leading to joint deformities and osteoarthritis. Here, we performed a detergent\u2010assisted bone wash using poloxamer 407 (P407) to clean the necrotic bone environment by removing lipids and necrotic debris. The new concept was tested using an established ex vivo AVN model of porcine cadaver humeral heads. The P407 wash was performed using P407 solution and followed with saline via two intraosseous needles. Visual inspection and image analyses of average pixel light intensity showed that the P407 wash produced a better\u2010cleaned bone than the saline wash. Analyses of the collected bone wash solution showed a two\u2010fold increase in triglycerides (101 vs. 53\u2009mmol\/head, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) and a 10\u2010fold increase in the dry weight of the removed debris (1.34 vs. 0.13\u2009g\/head, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) with the P407 wash compared to saline. The histological evaluation showed significantly decreased Oil\u2010Red\u2010O (fats) staining in the P407\u2010washed bone compared with the saline\u2010washed bone. The in vitro assays of Alizarin red and qPCR showed the P407 wash neither altered the osteogenic behaviors of porcine bone marrow\u2010derived mesenchymal cells (pBMMCs) nor raised inflammatory responses of porcine bone marrow\u2010derived macrophages (pBMMs). In conclusion, detergent\u2010assisted bone wash using P407 produced a better removal of nonsoluble debris from the bone marrow space than the saline wash without causing changes to osteogenesis or inflammatory reactions.<\/jats:p>","DOI":"10.1002\/jor.25496","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T13:01:31Z","timestamp":1669899691000},"page":"1482-1493","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ex vivo study of detergent\u2010assisted intraosseous bone wash treatment of osteonecrosis"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2935-8861","authenticated-orcid":false,"given":"Graham","family":"Andre","sequence":"first","affiliation":[{"name":"Center for Excellence in Hip Scottish Rite for Children Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Boschetto","sequence":"additional","affiliation":[{"name":"Center for Excellence in Hip Scottish Rite for Children Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishal","family":"Gokani","sequence":"additional","affiliation":[{"name":"Center for Excellence in Hip Scottish Rite for Children Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mo","family":"Singhal","sequence":"additional","affiliation":[{"name":"Center for Excellence in Hip Scottish Rite for Children Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Orthodontics Texas A&amp;M School of Dentistry Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0330-4777","authenticated-orcid":false,"given":"Harry K. 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