Reichert J C, Epari D R, Wullschleger M E, Berner A, Saifzadeh S, Nöth U, Dickinson I C, Schuetz M A, Hutmacher D W
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australien.
Orthopade. 2012 Apr;41(4):280-7. doi: 10.1007/s00132-011-1855-x.
Well-established therapies for bone defects are restricted to bone grafts which face significant disadvantages (limited availability, donor site morbidity, insufficient integration). Therefore, the objective was to develop an alternative approach investigating the regenerative potential of medical grade polycaprolactone-tricalcium phosphate (mPCL-TCP) and silk-hydroxyapatite (silk-HA) scaffolds.Critical sized ovine tibial defects were created and stabilized. Defects were left untreated, reconstructed with autologous bone grafts (ABG) and mPCL-TCP or silk-HA scaffolds. Animals were observed for 12 weeks. X-ray analysis, torsion testing and quantitative computed tomography (CT) analyses were performed. Radiological analysis confirmed the critical nature of the defects. Full defect bridging occurred in the autograft and partial bridging in the mPCL-TCP group. Only little bone formation was observed with silk-HA scaffolds. Biomechanical testing revealed a higher torsional moment/stiffness (p < 0.05) and CT analysis a significantly higher amount of bone formation for the ABG group when compared to the silk-HA group. No significant difference was determined between the ABG and mPCL-TCP groups. The results of this study suggest that mPCL-TCP scaffolds combined can serve as an alternative to autologous bone grafting in long bone defect regeneration. The combination of mPCL-TCP with osteogenic cells or growth factors represents an attractive means to further enhance bone formation.
成熟的骨缺损治疗方法仅限于骨移植,但骨移植存在明显缺点(可用性有限、供体部位发病、整合不足)。因此,目标是开发一种替代方法,研究医用级聚己内酯-磷酸三钙(mPCL-TCP)和丝素-羟基磷灰石(丝素-HA)支架的再生潜力。制造并固定临界尺寸的绵羊胫骨缺损。缺损不进行处理,用自体骨移植(ABG)以及mPCL-TCP或丝素-HA支架进行重建。对动物观察12周。进行X射线分析、扭转测试和定量计算机断层扫描(CT)分析。放射学分析证实了缺损的严重性。自体移植组出现完全的缺损桥接,mPCL-TCP组出现部分桥接。丝素-HA支架组仅观察到少量骨形成。生物力学测试显示,与丝素-HA组相比,ABG组的扭转力矩/刚度更高(p < 0.05),CT分析显示ABG组的骨形成量显著更高。ABG组和mPCL-TCP组之间未确定显著差异。本研究结果表明,mPCL-TCP支架组合可作为长骨缺损再生中自体骨移植的替代方法。mPCL-TCP与成骨细胞或生长因子的组合是进一步增强骨形成的有吸引力的手段。