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β-磷酸三钙作为兽医骨科中的一种合成松质骨移植材料:13例临床病例的回顾性研究

Beta-tricalcium phosphate as a synthetic cancellous bone graft in veterinary orthopaedics: a retrospective study of 13 clinical cases.

作者信息

Franch J, Díaz-Bertrana C, Lafuente P, Fontecha P, Durall I

机构信息

Surgery Department, Veterinary School of Barcelona, 08193 Bellaterra, Barcelona, Spain.

出版信息

Vet Comp Orthop Traumatol. 2006;19(4):196-204.

Abstract

The clinical use of beta-tricalcium phosphate (beta-TCP) as a synthetic cancellous bone graft in veterinary orthopaedics is herein reported. The retrospective study was based on 13 clinical cases belonging to 11 dogs and one cat. The weights of the dogs ranged from 3.4 to 48 kg. One female cat weighing 3.5 kg completed the study. The clinical cases were six arthrodeses (four carpal, two tarsal), one hypertrophic non-union (femur), one atrophic non-union (metacarpal bones) and five long-bone fractures (two femurs, one tibia, two radii) possessing subcritical-sized bone defects. The beta-TCP used in this study was presented as irregular interconnected- porous granules and was placed in the bone defects after mixing it with fresh blood. Bone healing was achieved at between eight and 12 weeks in all clinical cases except for the case of the chronic atrophic nonunion in which only one of the four metacarpal bones healed. In the 12 successful cases, the bone defect grafted with beta-TCP showed a radiological bone ingrowth of 100% (10 cases), 90% (one case) and 75% (one case). The complete lack of tissue adverse effects in our series, and the good defect healing, allows us to hypothesise that beta-TCP can be successfully used as a synthetic bone graft in bone defects with good local biological conditions and where osteoconduction is especially needed for assuring a structural scaffold for new-bone ingrowth. When, in addition to osteoconduction, osteoinduction and osteogenesis are necessary for defect healing, the fresh cancellous bone graft remains the gold standard in veterinary orthopaedics.

摘要

本文报道了β-磷酸三钙(β-TCP)作为一种人工松质骨移植材料在兽医骨科临床中的应用。这项回顾性研究基于11只犬和1只猫的13个临床病例。犬的体重范围为3.4至48千克。一只体重3.5千克的雌性猫完成了该研究。临床病例包括6例关节融合术(4例腕关节,2例跗关节)、1例肥大性骨不连(股骨)、1例萎缩性骨不连(掌骨)和5例长骨骨折(2例股骨、1例胫骨、2例桡骨),均存在临界尺寸以下的骨缺损。本研究中使用的β-TCP为不规则相互连通的多孔颗粒,与新鲜血液混合后植入骨缺损处。除慢性萎缩性骨不连病例中4根掌骨仅有1根愈合外,所有临床病例均在8至12周实现了骨愈合。在12例成功病例中,植入β-TCP的骨缺损处放射学显示骨长入率分别为100%(10例)、90%(1例)和75%(1例)。我们的系列研究中完全没有组织不良反应,且骨缺损愈合良好,这使我们推测,在局部生物学条件良好且特别需要骨传导以确保新骨长入的结构支架的骨缺损中,β-TCP可成功用作人工骨移植材料。当除骨传导外,骨缺损愈合还需要骨诱导和成骨作用时,新鲜松质骨移植在兽医骨科中仍是金标准。

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