Wang Yan, Ni Ming, Tang Pei-Fu, Li Gang
Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, Beijing, People's Republic of China.
J Orthop Res. 2009 Apr;27(4):477-82. doi: 10.1002/jor.20782.
This study tested the hypothesis that use of biomaterials in distraction osteogenesis (DO) would reduce the treatment time and enhance bone formation quality. A 1.0-cm tibial shaft was removed in the left tibia of 36 rabbits. Rabbits were randomly divided into three groups: group A, the defect gap was reduced with the tibia shortened for 1.0-cm; group B, the defect gap was filled with 1.0-cm restorable porous hydroxyapatite and Tri-calcium phosphates cylindrical block (HA/TCP block, diameter is 0.5-cm); group C, The 1.0-cm defect gap was reduced 0.5 cm and the remaining 0.5-cm defect gap was filled with the 0.5-cm HA/TCP block. The tibia was then fixed with unilateral lengthener; for groups A and C; lengthening started 7 days after surgery at a rate of 1.0 mm/day, in two steps. Group A received lengthening for 10 days and group C for 5 days, there was no lengthening for group B. All animals were terminated at day 37 following surgery. The excised bone specimens were subject to microcomputed tomography (micro-CT), mechanical testing, and histological examinations. Bone mineral density and content and tissue mineral density and content, as well as the mechanical properties of the regenerates were significantly higher in group C compared to groups A and B. Micro-CT and histological examinations also confirmed that the regenerates in Group C had most advanced bone formation, consolidation, and remodeling compared to other groups. In conclusion, the combined use of biomaterials and DO technique can reduce the treatment time and enhance bone consolidation in bone defect management.
在牵张成骨术(DO)中使用生物材料可缩短治疗时间并提高骨形成质量。在36只兔子的左胫骨上切除1.0厘米的胫骨干。兔子被随机分为三组:A组,缺损间隙随胫骨缩短1.0厘米而减小;B组,缺损间隙用1.0厘米可恢复的多孔羟基磷灰石和磷酸三钙圆柱形块(HA/TCP块,直径0.5厘米)填充;C组,1.0厘米的缺损间隙减小0.5厘米,剩余0.5厘米的缺损间隙用0.5厘米的HA/TCP块填充。然后用单侧延长器固定胫骨;对于A组和C组,术后7天开始延长,速率为每天1.0毫米,分两步进行。A组延长10天,C组延长5天,B组不延长。所有动物在术后第37天处死。切除的骨标本进行显微计算机断层扫描(micro-CT)、力学测试和组织学检查。与A组和B组相比,C组的骨矿物质密度和含量、组织矿物质密度和含量以及再生骨的力学性能显著更高。Micro-CT和组织学检查也证实,与其他组相比,C组的再生骨具有最先进的骨形成、骨痂形成和重塑。总之,生物材料与DO技术联合使用可缩短骨缺损治疗时间并增强骨痂形成。