K. U. Leuven, Department of Development and Regeneration, Biomedical Sciences Kulak, Etienne Sabbelaan 53, B-8500 Kortrijk, Belgium.
Bone Joint J. 2013 Nov;95-B(11):1514-20. doi: 10.1302/0301-620X.95B11.30458.
The osteoinductive properties of demineralised bone matrix have been demonstrated in animal studies. However, its therapeutic efficacy has yet to be proven in humans. The clinical properties of AlloMatrix, an injectable calcium-based demineralised bone matrix allograft, were studied in a prospective randomised study of 50 patients with an isolated unstable distal radial fracture treated by reduction and Kirschner (K-) wire fixation. A total of 24 patients were randomised to the graft group (13 men and 11 women, mean age 42.3 years (20 to 62)) and 26 to the no graft group (8 men and 18 women, mean age 45.0 years (17 to 69)). At one, three, six and nine weeks, and six and 12 months post-operatively, patients underwent radiological evaluation, assessments for range of movement, grip and pinch strength, and also completed the Disabilities of Arm, Shoulder and Hand questionnaire. At one and six weeks and one year post-operatively, bone mineral density evaluations of both wrists were performed. No significant difference in wrist function and speed of recovery, rate of union, complications or bone mineral density was found between the two groups. The operating time was significantly higher in the graft group (p = 0.004). Radiologically, the reduction parameters remained similar in the two groups and all AlloMatrix extraosseous leakages disappeared after nine weeks. This prospective randomised controlled trial did not demonstrate a beneficial effect of AlloMatrix demineralised bone matrix in the treatment of this category of distal radial fractures treated by K-wire fixation.
脱矿骨基质的成骨特性已在动物研究中得到证实。然而,其在人类中的治疗效果尚未得到证实。同种异体脱矿骨基质 AlloMatrix 是一种可注射的钙基脱矿骨基质移植物,在一项前瞻性随机研究中对 50 例单独不稳定桡骨远端骨折患者进行了研究,这些患者通过复位和克氏针(K-)固定进行治疗。共有 24 例患者随机分为移植物组(13 名男性和 11 名女性,平均年龄 42.3 岁(20 至 62 岁))和 26 名无移植物组(8 名男性和 18 名女性,平均年龄 45.0 岁(17 至 69 岁))。术后 1、3、6 和 9 周以及 6 和 12 个月,患者接受影像学评估、运动范围评估、握力和捏力评估,并完成上肢功能障碍问卷(DASH)。术后 1、6 周和 1 年,对双侧腕部进行骨密度评估。两组间腕部功能、恢复速度、愈合率、并发症或骨密度无显著差异。移植物组的手术时间明显更长(p = 0.004)。影像学上,两组的复位参数相似,所有 AlloMatrix 骨外漏在 9 周后均消失。这项前瞻性随机对照试验并未显示 AlloMatrix 脱矿骨基质在治疗此类经克氏针固定的桡骨远端骨折方面具有有益效果。