JHS - 2026-03-03 - Journal Article
Missouri Osteochondral Preservation System for Nerve Preservation of Nerve Isografts Improves Functional Recovery After Peripheral Nerve Reconstruction With Polyethylene Glycol-Mediated Fusion.
Nuelle JAV, Rizvanović BF, Golden A, Bozynski CC, Stoker A, Cook JL
Topics
Key Takeaway
MOPS-N preserved nerve isografts combined with PEG-fusion achieved significantly higher sciatic functional index scores and near-baseline grip strength by week 4 compared to autografts without PEGf and Normosol-preserved grafts in an 8-mm rat sciatic nerve gap model.
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Summary
This study tested whether MOPS-N preservation combined with PEG-mediated fusion improves peripheral nerve reconstruction outcomes in an 8-mm rat sciatic nerve gap model across six randomized groups including autograft controls and Normosol-preserved isografts. MOPS-N groups (28-day and 56-day storage) outperformed all comparators on sciatic functional index, rotarod performance, and grip strength by weeks 3-6, with grip strength approaching baseline by week 4. Histomorphometric analysis demonstrated more uniform G-ratios and superior gastrocnemius muscle mass ratios in MOPS-N groups, indicating better axonal integrity and target muscle reinnervation.
Key Limitation
The study uses an inbred syngeneic Lewis rat isograft model, which eliminates immune rejection and does not address the immunogenicity of MOPS-N-stored allografts that would be required for clinical translation.
Original Abstract
PURPOSE
Functional outcomes after peripheral nerve reconstruction remain suboptimal, particularly for large-gap defects. This study evaluated the combined use of the Missouri Osteochondral Preservation System for nerve (MOPS-N) preservation for nerve isografts and polyethylene glycol-mediated fusion (PEGf) in a rat sciatic nerve gap model.
METHODS
Adult male Lewis rats underwent an 8-mm sciatic nerve gap reconstruction. Animals were randomized to the following 6 groups: (1) MOPS-N isografts stored 28 days + PEGf, (2) MOPS-N isografts stored 56 days + PEGf, (3) Normosol-preserved isografts stored 28 days + PEGf, (4) Normosol-preserved isografts stored 56 days + PEGf, (5) autograft, and (6) autograft + PEGf. Functional outcomes were assessed through sciatic functional index, rotarod performance, and hindlimb grip strength testing over 6 weeks. At end point, gastrocnemius muscle mass ratios were measured, and nerve segments underwent histomorphometric analysis for G-ratio evaluation.
RESULTS
MOPS-N groups consistently outperformed Normosol groups and autografts without PEGf. By week 6, both MOPS-N groups achieved significantly higher sciatic function index scores than both autograft groups and Normosol groups. Rotarod times were significantly greater in both MOPS-N groups and autograft + PEG group than Normosol across weeks 3-6. Grip strength recovery approached baseline in both MOPS-N groups and autograft + PEG group by week 4, whereas autografts without PEG and Normosol grafts remained impaired. Muscle mass ratios were highest in MOPS-N groups. Histomorphometric analysis of nerve segments showed MOPS-N groups maintained more uniform G-ratios across segments.
CONCLUSIONS
MOPS-N-preserved viable nerve isografts combined with PEG-fusion promoted superior functional recovery, muscle reinnervation, and axonal integrity compared with autografts and Normosol preservation.
CLINICAL RELEVANCE
This strategy has potential to address the barrier of limited shelf-life of stored viable peripheral nerve tissue, expanding the translational potential of viable nerve grafts for reconstruction of large-gap peripheral nerve injuries. Additional studies are needed to assess the immunogenicity of MOPS-N-stored allografts.