Dias Maria Isabel, Lourenço Paulo, Rodrigues Adriano, Azevedo Jorge, Viegas Carlos, Ferreira António, Cabrita António Silvério
Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
Acta Med Port. 2007 Jan-Feb;20(1):37-46. Epub 2007 May 23.
This study aimed at studying the influence of the quantitative variation of the autologous spongy bone graft on its osteogenic properties by virtue of the fact that its attainment has inconveniences of significant morbidity at local donor level and the limited quantity of grafting able to be obtained. Recourse was made to an osteotomy model for this purpose with the removal of a small 4 mm segment at the mid-diaphysis of the left tibia of twenty one sheep, stabilised by an osteosynthesis plate on which different quantities of autografting spongy bone were applied so that the referred bone defect (1) would not to be completely filled (1.5 g), (2) would be filled without any compression (3 g) and (3) would be filled with an excessive quantity (5 g) (n=5/each group). (4) A control osteotomy (n=6) was also carried out where the bone defect remained empty. Comparison of the evolution of bone regeneration during the postoperative period of 12 weeks was carried out by means of conventional radiographic exams and optical densitometry analysis and by radiological bone densitometry (DEXA--Dual-Energy X-ray Absorptiometry), bone histomorphometry and histological analysis after the animals' euthanasia. Optical density was significantly affected (p<0.0001) by the treatment and by time and with significant differences between the various groups under study over the same time of post-operative period: during immediate postoperative and on the 2nd (p <0.01), 4th (p <0.001), 6th and 8th weeks (p <0.05), but not on the 10th and 12th (p >0.05) post-operative weeks. Bone mineral density (BMD), obtained by DEXA, was 0.4347 +/- 0.3821 g/cm2 in the control group and 0.7482 +/- 0.2327 g/cm2, 0.9517 +/- 0.2292 g/cm2 e 1.0409 +/- 0.0681 g/cm2 in the groups that had received 1.5 g, 3g and 5 g of bone graft, respectively. The BV was 39.2 +/- 24.4% with the control group and 62.0 +/- 14.4%, 76.0 +/- 15.2% and 84.0+/-4.2% in the groups that had received 1.5 g, 3g and 5 g of bone graft, respectively. The BMD and BV were significantly affected (p<0.05 and p <0.01, respectively) by the treatment, nevertheless, there were no significant differences (p >0.05) between the groups that had received the largest volumes of autografting spongy bone on the 12th week of the post-operative period.The conclusion was reached that there was no advantage in excessively filling an osteotomy gap with autografting spongy bone and attainment of only the volume strictly required to fill the osteotomy gap at issue was needed.
本研究旨在探讨自体松质骨移植量的变化对其成骨特性的影响。由于获取自体松质骨会给局部供区带来明显的并发症，且获取的移植骨量有限。为此采用截骨模型，在21只绵羊的左胫骨骨干中部切除一小段4mm的骨段，用接骨板固定，在接骨板上施加不同量的自体松质骨，使骨缺损（1）不完全填充（1.5g），（2）无压缩填充（3g），（3）过量填充（5g）（每组n = 5）。（4）还进行了对照截骨（n = 6），骨缺损处保持空虚。通过传统的X线检查、光学密度测定分析以及放射性骨密度测定（DEXA - 双能X线吸收法）、骨组织形态计量学和动物安乐死后的组织学分析，比较术后12周内骨再生的演变情况。光学密度受治疗和时间的显著影响（p <0.0001），在术后同期各研究组之间存在显著差异：术后即刻以及术后第2周（p <0.01）、第4周（p <0.001）、第6周和第8周（p <0.05），但在术后第10周和第12周（p>0.05）无差异。通过DEXA获得的对照组骨矿物质密度（BMD）为0.4347±0.3821g/cm²，接受1.5g、3g和5g骨移植的组分别为0.7482±0.2327g/cm²、0.9517±0.2292g/cm²和1.0409±0.0681g/cm²。对照组的骨体积（BV）为39.2±24.4%，接受1.5g、3g和5g骨移植的组分别为62.0±14.4%、76.0±15.2%和84.0±4.2%。治疗对BMD和BV有显著影响（分别为p <0.05和p <0.01），然而，在术后第12周，接受最大量自体松质骨移植的组之间无显著差异（p>0.05）。得出的结论是，用自体松质骨过度填充截骨间隙没有优势，只需获得严格填充所讨论截骨间隙所需的体积即可。
