Department of Orthopedics, Martin Luther University of Halle-Wittenberg, Halle 06097, Germany.
J Biomed Mater Res B Appl Biomater. 2010 Jan;92(1):215-25. doi: 10.1002/jbm.b.31508.
Because complications of distraction osteogenesis are largely related to the long duration of therapy, increasing efforts were reached to shorten treatment by using osteoconductive replacement materials incorporating bioactive molecules such as IGF-1 and TGF-beta1. The controlled release of IGF-1 and TGF-beta1 from coated biodegradable poly(D,L-lactide) implants could stimulate fracture healing locally. We investigated the effect of locally applied IGF-1 and TGF-beta1 from IGF-1/TGF-beta1-enriched polylactide membranes on fracture healing in a sheep model of delayed callus formation. Twenty-eight sheep were used for this study. Callus distraction of 1 mm/day by means of a unilateral fixator was continued for 30 days. At the beginning of the subsequent consolidation phase, either growth factors were applied locally or the defect was packed with cancellous bone, or both. The groups treated with growth factors were compared to a control group. The consolidation phase lasted for 60 days and both tibiae were dissected for histological and histomorphometric analyses. This investigation found a reduced absolute callus area in the lengthening zone in all treatment groups. The two treatment groups that received a membrane coated with growth factors showed distinctly higher relative bone areas than the groups treated with an uncoated membrane or packing of the osteotomy defect with cancellous bone. The differences in bone areas were not statistically significant. Application of the growth factors accelerated bone healing and achieved results comparable with those of established treatment methods (packing with autologous cancellous bone). The best results were achieved with a combination of both methods.
由于骨延长术的并发症在很大程度上与治疗时间长有关，因此人们越来越努力地通过使用含有生物活性分子（如 IGF-1 和 TGF-β1）的骨传导替代材料来缩短治疗时间。IGF-1 和 TGF-β1 从涂层可生物降解的聚（D，L-丙交酯）植入物中的受控释放可以局部刺激骨折愈合。我们研究了 IGF-1/TGF-β1 丰富的聚乳酸膜中局部应用 IGF-1 和 TGF-β1 对绵羊延迟性骨痂形成模型骨折愈合的影响。本研究使用了 28 只绵羊。通过单侧固定器每天将骨痂延长 1mm，持续 30 天。在随后的巩固阶段开始时，局部应用生长因子或用松质骨填充缺损，或两者兼用。用生长因子治疗的组与对照组进行比较。巩固阶段持续 60 天，然后对两只胫骨进行解剖以进行组织学和组织形态计量学分析。这项研究发现，所有治疗组的延长区的绝对骨痂面积都减少了。接受生长因子涂层膜治疗的两组的相对骨面积明显高于接受未涂层膜或用松质骨填充骨切开缺损的组。骨面积的差异无统计学意义。应用生长因子可加速骨愈合，并取得与已建立的治疗方法（用自体松质骨填充）相当的结果。两种方法的联合应用效果最佳。
