Yasuda Hiroyuki, Yano Koichi, Wakitani Shigeyuki, Matsumoto Tomiya, Nakamura Hiroaki, Takaoka Kunio
Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
J Orthop Sci. 2012 May;17(3):299-307. doi: 10.1007/s00776-012-0196-x. Epub 2012 Jan 21.
Massive frozen stocked allogeneic bone grafts are often used to reconstruct large bone defects caused by trauma or tumor resections. However, the long-term failure rate of such massive allografts was reported to be 25% because of infection, fracture, and nonunion. In this study, we evaluated the ability of a recombinant human bone morphogenetic protein (rhBMP)-2-retaining paste to promote the osteogenic potential of frozen stocked allogeneic bone grafts to repair intercalated femoral shaft defects in a rat model.
After confirming the transplantation intolerance between two rat strains (Wistar and Lewis) by skin transplantation from Lewis rats to Wistar rats, an 8-mm-long bone segment was removed from the Wistar rats, and a frozen stocked allograft coated with the rhBMP-2-retaining paste from the Lewis rats was placed into the defect and subjected to intramedullary fixation with an 18-gauge injection needle pin. The allografted femurs were evaluated by radiographic, histologic, and biomechanical examinations at specified time points.
The results revealed successful repair of critical-size cortical bone defects by implanting frozen stocked allografts coated with the rhBMP-2-retaining synthetic biodegradable carrier paste from an immunologically intolerant host.
This experimental study suggest that allogeneic bone grafting in combination with rhBMP-2 and its local delivery system may represent an innovative approach to the reconstruction of bone defects.
大量冷冻保存的同种异体骨移植常用于修复由创伤或肿瘤切除引起的大骨缺损。然而，据报道，由于感染、骨折和骨不连，这种大量同种异体移植的长期失败率为25%。在本研究中，我们评估了一种保留重组人骨形态发生蛋白（rhBMP）-2的糊剂促进冷冻保存的同种异体骨移植的成骨潜力，以修复大鼠模型中股骨中段缺损的能力。
通过从Lewis大鼠到Wistar大鼠的皮肤移植确认两种大鼠品系（Wistar和Lewis）之间的移植不耐受后，从Wistar大鼠中取出一段8毫米长的骨段，将涂有来自Lewis大鼠的保留rhBMP-2的糊剂的冷冻保存同种异体骨植入缺损处，并用一根18号注射针进行髓内固定。在特定时间点通过影像学、组织学和生物力学检查评估同种异体移植的股骨。
结果显示，通过植入来自免疫不耐受宿主的涂有保留rhBMP-2的合成可生物降解载体糊剂的冷冻保存同种异体骨，成功修复了临界尺寸的皮质骨缺损。
本实验研究表明，同种异体骨移植联合rhBMP-2及其局部递送系统可能是一种创新的骨缺损重建方法。
