Department of Orthopedic Surgery, Technical University of Munich, Germany.
Anticancer Res. 2011 Apr;31(4):1235-9.
Bone defects due to malignant tumor often lead to repeated surgery or amputation. Thus, a major objective in orthopedic surgery is the extracorporeal devitalization of tumor-bearing bone segments following reimplantation. Extracorporeal irradiation or autoclaving are possible methods even though they may cause severe loss of biomechanical and biological properties. Yet previous studies have shown that high hydrostatic pressure (HHP) allows for complete devitalization of tumor-afflicted bone segments, while the biomechanical and biological properties of bone tissue remained unchanged. The subject of the present study is revitalization of human bone segments after HHP treatment to acquire knowledge about the ingrowth and regeneration of osteoblast-like cells after such treatment.
Bone pieces of 5 mm(3) were obtained from cancellous bone, taken from human femoral heads of 6 patients undergoing surgery for total hip arthroplasty, and exposed to hydrostatic pressure levels of 0, 300, and 600 MPa for 10 min at 37°C. Following the HHP treatment, bone segments were coated with primary human bone cells (10,000 cells/segment), cultured for 42 days and cell viability and proliferation quantified at different time points.
An adhesion rate of 73.8% on day 1 and an increase in proliferation between day 14 and 42 were determined. Pretreatment of bone segments with 300 and 600 MPa did not affect cell adhesion or proliferation. Histology showed intact cells and new bone formation on the bone specimens; elevated expression of alkaline phosphatase, osteocalcin, and collagen type I was seen by immunohistochemistry.
The present study demonstrates, for the first time, the successful revitalization of HHP-treated bone segments. Concerning proliferation and osteogenic differentiation, the findings are a promising demonstration of sufficient osseointegration. Along with previous results, we anticipate that a pressure of a maximum 350 MPa does induce devitalization of malignant bone tumor segments, while HHP treatment of bone matrix up to 600 MPa does not affect osteoconductivity and osteoinductivity.
恶性肿瘤导致的骨缺损常导致反复手术或截肢。因此，矫形外科的一个主要目标是在肿瘤骨段再植入后进行体外去活。体外照射或高压灭菌是可能的方法，尽管它们可能导致严重的生物力学和生物学特性丧失。然而，先前的研究表明，高静压（HHP）允许完全去活受肿瘤影响的骨段，而骨组织的生物力学和生物学特性保持不变。本研究的主题是在 HHP 处理后使人类骨段复活，以了解此类处理后成骨样细胞的向内生长和再生情况。
从 6 名接受全髋关节置换术的患者的股骨头上取下 5mm(3)的骨块，在 37°C 下用 0、300 和 600 MPa 的静压水平暴露 10 分钟。HHP 处理后，用原代人骨细胞（每个骨段 10,000 个细胞）对骨段进行涂层，培养 42 天，并在不同时间点量化细胞活力和增殖。
第 1 天的黏附率为 73.8%，第 14 天至第 42 天的增殖增加。300 和 600 MPa 预处理骨段不影响细胞黏附和增殖。组织学显示骨标本上有完整的细胞和新骨形成；免疫组织化学显示碱性磷酸酶、骨钙素和胶原 I 表达升高。
本研究首次成功复活了 HHP 处理的骨段。关于增殖和成骨分化，这些发现是充分骨整合的有希望的证明。结合以前的结果，我们预计最大 350 MPa 的压力确实会诱导恶性骨肿瘤段的去活，而高达 600 MPa 的 HHP 处理骨基质不会影响骨传导性和骨诱导性。
