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两种剂量的重组人骨形态发生蛋白在可吸收胶原海绵中用于犬骨愈合的比较。

Comparison of two doses of recombinant human bone morphogenetic protein in absorbable collagen sponges for bone healing in dogs.

作者信息

Schmiedt Chad W, Lu Yan, Heaney Kathleen, Muir Peter, Amodie Deborah M, Markel Mark D

机构信息

Comparative Orthopaedic Research Laboratory, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706-1100, USA.

出版信息

Am J Vet Res. 2007 Aug;68(8):834-40. doi: 10.2460/ajvr.68.8.834.

Abstract

OBJECTIVE

To determine the effects of 2 doses of recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge (rhBMP-2/ACS) on bone healing in dogs.

ANIMALS

27 adult dogs.

PROCEDURES

Dogs underwent a mid-diaphyseal (1-mm) tibial osteotomy (stabilized with external skeletal fixation) and received an ACS containing 0.28 mg (0.2 mg/mL) or 0.56 mg (0.4 mg/mL) of rhBMP-2 or no treatment (control dogs). All dogs were examined daily; bone healing was assessed via radiography and subjective lameness evaluation every 2 weeks. After euthanasia at 8 weeks, tibiae were evaluated biomechanically and histologically.

RESULTS

Control dogs required antimicrobial treatment for pin-site-related complications more frequently than did rhBMP-2/ACS-treated dogs. At 4 and 6 weeks, weight bearing was greater in dogs treated with rhBMP-2/ACS (0.2 mg/mL) than in control dogs, albeit not significantly. Compared with control treatment, both doses of rhBMP-2/ACS accelerated osteotomy healing at 4, 6, and 8 weeks, and the 0.2 mg/mL dose enhanced healing at 2 weeks; healing at 6 weeks was greater for the lower-dose treatment than for the higher-dose treatment. Histologically, healing at 8 weeks was significantly improved for both rhBMP-2/ACS treatments, compared with control treatment. Among groups, biomechanical variables did not differ, although less osteotomy-site failures occurred in rhBMP-2/ACS-treated groups.

CONCLUSIONS AND CLINICAL RELEVANCE

In dogs that underwent tibial osteotomy, rhBMP-2/ACS (0.2 mg/mL) appeared to accelerate bone healing and reduce lameness (compared with control treatment) and apparently augmented bone healing more than rhBMP-2/ACS (0.4 mg/mL). Compared with control dogs, rhBMP-2/ACS-treated dogs required antimicrobial treatments less frequently.

摘要

目的

确定两种剂量的重组人骨形态发生蛋白-2负载于可吸收胶原海绵(rhBMP-2/ACS)对犬骨愈合的影响。

动物

27只成年犬。

方法

犬接受胫骨骨干中部(1毫米)截骨术(采用外骨骼固定稳定),并接受含0.28毫克(0.2毫克/毫升)或0.56毫克(0.4毫克/毫升)rhBMP-2的ACS治疗,或不接受治疗(对照犬)。所有犬每天接受检查;每2周通过X线摄影和主观跛行评估来评估骨愈合情况。在8周时实施安乐死后,对胫骨进行生物力学和组织学评估。

结果

对照犬因针道相关并发症而需要抗菌治疗的频率高于接受rhBMP-2/ACS治疗的犬。在4周和6周时,接受rhBMP-2/ACS(0.2毫克/毫升)治疗的犬负重比对照犬更大,尽管差异不显著。与对照治疗相比,两种剂量的rhBMP-2/ACS在4周、6周和8周时均加速了截骨愈合,0.2毫克/毫升剂量在2周时促进了愈合;低剂量治疗在6周时的愈合情况优于高剂量治疗。组织学上,与对照治疗相比,两种rhBMP-2/ACS治疗在8周时的愈合均有显著改善。在各治疗组之间,生物力学变量无差异,尽管rhBMP-2/ACS治疗组的截骨部位失败情况较少。

结论及临床意义

在接受胫骨截骨术的犬中,rhBMP-2/ACS(0.2毫克/毫升)似乎加速了骨愈合并减轻了跛行(与对照治疗相比),且明显比rhBMP-2/ACS(0.4毫克/毫升)更能增强骨愈合。与对照犬相比,接受rhBMP-2/ACS治疗的犬需要抗菌治疗的频率更低。

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