Oakes Daniel A, Lee Christopher C, Lieberman Jay R
Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, University of California-Los Angeles Medical Center, 10833 LeConte Avenue, Los Angeles, CA 90095, USA.
Clin Orthop Relat Res. 2003 Aug(413):281-90. doi: 10.1097/01.blo.0000073347.50837.16.
The osteoconductive and osteoinductive potential of two human allogeneic demineralized bone matrix putties were compared in a critical-sized athymic rat femoral defect model. Defects were treated with (1) a demineralized bone matrix in a hyaluronic acid carrier, (2) a demineralized bone matrix in a glycerol carrier, (3) a hyaluronic acid carrier alone, or (4) with no implant. Radiographic examinations and histologic analyses were done at 4, 8, and 16 weeks postoperatively. Eight of the 48 defects treated with a demineralized bone matrix and none of the 36 surgical controls showed complete radiographic healing by 16 weeks and no statistically significant difference between the radiographic scores for the two demineralized bone matrix preparations was found. On histologic review, both preparations of demineralized bone matrix had passive remineralization. The largest foci of endochondral ossification were seen in limbs treated with a demineralized bone matrix in a hyaluronic acid carrier. The 8-mm rat femoral defect allows for stringent assessment of the osteoinductive potential of bone graft substitutes. Hyaluronic acid and glycerol are viable carriers for demineralized bone matrices. As both de-mineralized bone matrices tested provided an adequate osteoconductive matrix and showed some, although limited, osteoinductive capacity, these materials should be used in clinical practice only as bone graft extenders or enhancers.
在一个临界大小的无胸腺大鼠股骨缺损模型中，比较了两种人同种异体脱矿骨基质糊剂的骨传导和骨诱导潜力。缺损分别用以下方法处理：（1）透明质酸载体中的脱矿骨基质；（2）甘油载体中的脱矿骨基质；（3）单独的透明质酸载体；或（4）不植入任何材料。在术后4周、8周和16周进行影像学检查和组织学分析。在接受脱矿骨基质治疗的48处缺损中，有8处到16周时显示出完全的影像学愈合，而在36个手术对照组中无一例出现这种情况，并且两种脱矿骨基质制剂的影像学评分之间未发现统计学上的显著差异。组织学检查发现，两种脱矿骨基质制剂均有被动再矿化现象。在接受透明质酸载体中的脱矿骨基质治疗的肢体中，观察到最大的软骨内成骨灶。8毫米的大鼠股骨缺损可严格评估骨移植替代物的骨诱导潜力。透明质酸和甘油是脱矿骨基质的可行载体。由于所测试的两种脱矿骨基质均提供了足够的骨传导基质，并显示出一定的（尽管有限）骨诱导能力，因此这些材料在临床实践中仅应作为骨移植扩展剂或增强剂使用。
