Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Osteoarthritis Cartilage. 2013 Nov;21(11):1746-54. doi: 10.1016/j.joca.2013.07.014. Epub 2013 Jul 27.
The purpose of this study was to evaluate the effectiveness of demineralized bone matrix (DBM) with and without platelet-rich plasma (PRP) in the treatment of osteochondral defects (OCDs) of the talus. We hypothesized that treatment with DBM would result in more bone formation than no treatment in control OCDs, and that PRP would further enhance the regenerative capacity of DBM.
A standardized 6-mm OCD was created in each talus of 16 adult goats. According to a randomization scheme, one OCD of each goat was treated with allogeneic DBM hydrated with normal saline (n = 8) or hydrated with autologous PRP (n = 8). The contralateral OCD (n = 16) served as control. After 24 weeks, the animals were euthanized and the tali excised. Various outcome parameters were analyzed with use of macroscopic evaluation, micro-computed tomography (μCT), histology, histomorphometry, and fluorescence microscopy.
None of the analyses revealed statistically significant differences between the groups for any of the parameters analyzed in any volume of interest. For example, the mean bone volume fraction (BV/TV) of the defect, as measured by μCT, was 0.56 (95% confidence interval [CI], 0.44-0.68) for DBM hydrated with normal saline and 0.52 (95% CI, 0.40-0.65) for DBM hydrated with PRP, compared to 0.53 (95% CI, 0.45-0.61) and 0.54 (95% CI, 0.44-0.64) for the internal controls, respectively (P > 0.05).
In contrast to our hypotheses, no beneficial treatment effect of DBM with or without PRP was found for OCDs of the caprine talus.
本研究旨在评估脱矿骨基质（DBM）联合或不联合富血小板血浆（PRP）治疗距骨骨软骨缺损（OCD）的疗效。我们假设，与对照组的 OCD 相比，DBM 治疗会导致更多的骨形成，而 PRP 会进一步增强 DBM 的再生能力。
在 16 只成年山羊的每只距骨上均建立一个标准化的 6mm OCD。根据随机分组方案，每只山羊的一个 OCD 用生理盐水（n=8）或自体 PRP 水化的同种异体 DBM（n=8）治疗。对侧 OCD（n=16）作为对照。24 周后，处死动物并取出距骨。使用宏观评估、微计算机断层扫描（μCT）、组织学、组织形态计量学和荧光显微镜分析各种结果参数。
在任何感兴趣的体积中，没有任何分析显示组间在任何分析参数上均存在统计学显著差异。例如，通过 μCT 测量的缺损的骨体积分数（BV/TV），生理盐水水化的 DBM 为 0.56（95%置信区间[CI]，0.44-0.68），PRP 水化的 DBM 为 0.52（95% CI，0.40-0.65），而内部对照分别为 0.53（95% CI，0.45-0.61）和 0.54（95% CI，0.44-0.64）（P>0.05）。
与我们的假设相反，未发现 DBM 联合或不联合 PRP 治疗山羊距骨 OCD 的有益治疗效果。
