Orthopaedic Department, Barmherzige Brüder Hospital, Esterhazystrasse 26, A-7000 Eisenstadt, Austria.
J Orthop Res. 2012 Oct;30(10):1563-9. doi: 10.1002/jor.22132. Epub 2012 Apr 16.
Treatment of delayed bone healing and non-unions after fractures, osteotomies or arthrodesis still is a relevant clinical challenge. Artificially applied growth factors can increase bone healing and progressively gain importance in clinical routine. The aim of this study was to determine the effects of rhPDGF-BB, rhVEGF-165, and rhBMP-2 in fibrin matrix on bone healing in a delayed-union rat model. Thirty-seven rats underwent a first operation where a standardized femoral critical size defect was created. A silicone spacer was implanted to impair vascularization within the defect. At 4 weeks the spacer was removed in a second operation and rhPDGF-BB, rhVEGF-165, or rhBMP-2 were applied in a fibrin clot. Animals in a fourth group received a fibrin clot without growth factors. At 8 weeks fibrin bound rhBMP-2 treated animals showed a significantly increased union rate and bone volume within the defect compared to the other groups. Single application of fibrin bound rhPDGF-BB and rhVEGF-165 failed to increase bone healing in our atrophic non-union model.
治疗骨折、截骨术或关节融合术后的延迟骨愈合和骨不连仍然是一个具有挑战性的临床问题。人工应用的生长因子可以促进骨愈合，并在临床常规中逐渐变得更加重要。本研究的目的是确定纤维蛋白基质中的 rhPDGF-BB、rhVEGF-165 和 rhBMP-2 对延迟愈合大鼠模型中骨愈合的影响。37 只大鼠接受了第一次手术，在股骨干制造了一个标准化的临界尺寸缺损。在缺损内植入了一个硅酮间隔物以阻止血管生成。4 周后，在第二次手术中取出间隔物，并在纤维蛋白凝块中应用 rhPDGF-BB、rhVEGF-165 或 rhBMP-2。第四组动物接受不含生长因子的纤维蛋白凝块。8 周时，与其他组相比，纤维蛋白结合 rhBMP-2 治疗的动物的愈合率和缺损内的骨体积明显增加。在我们的萎缩性骨不连模型中，单次应用纤维蛋白结合的 rhPDGF-BB 和 rhVEGF-165 未能增加骨愈合。
