Bosemark Per, Perdikouri Christina, Pelkonen Mea, Isaksson Hanna, Tägil Magnus
Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden.
J Orthop Res. 2015 Apr;33(4):488-95. doi: 10.1002/jor.22815. Epub 2015 Feb 12.
Long bone defects can be managed by the induced membrane technique together with autologous bone graft. However, graft harvest is associated with donor site morbidity. This study investigates if a tricalcium phosphate hydroxyapatite scaffold can be used alone or in combination with bone active drugs to improve healing. Sprague Dawley rats (n = 40) were randomized into four groups. (A) scaffold, (B) BMP-7, (C) BMP-7 + scaffold, and (D) BMP-7 + scaffold + systemic bisphosphonate at 2 weeks. Locked femoral nailing was followed by 6 mm segment removal and implantation of an epoxy spacer. At 4 weeks, the spacers were removed and the defects grafted. Eleven weeks later, the bones were explanted for evaluation with radiography, manual assessment, micro-CT, histology, and Fourier Transform Infrared spectroscopy (FTIR). Isolated scaffolds (A) did not heal any defects, whereas the other treatments led to healing in 7/10 (B), 10/10 (C), and 9/10 (D) rats. Group D had greater volume of highly mineralized bone (p < 0.01) and higher bone volume fraction (p < 0.01) compared to all other groups. A synthetic scaffold + BMP-7 combined with a bisphosphonate improved the callus properties in a rat femoral critical size defect, compared to both BMP-7 and scaffold alone or the two combined.
长骨缺损可以通过诱导膜技术联合自体骨移植来处理。然而，取骨会引发供区并发症。本研究调查磷酸三钙羟基磷灰石支架能否单独使用或与骨活性药物联合使用以促进愈合。将40只斯普拉格-道利大鼠随机分为四组。(A) 支架组，(B) 骨形态发生蛋白-7（BMP-7）组，(C) BMP-7 + 支架组，以及(D) 在第2周使用BMP-7 + 支架 + 全身双膦酸盐组。先行锁定髓内钉固定，然后切除6毫米节段并植入环氧间隔物。4周时，取出间隔物并对缺损处进行植骨。11周后，取出骨骼，通过X线摄影、手动评估、显微CT、组织学和傅里叶变换红外光谱（FTIR）进行评估。单独的支架（A）未能使任何缺损愈合，而其他治疗方法使7/10（B）、10/10（C）和9/10（D）的大鼠实现了愈合。与所有其他组相比，D组具有更大体积的高度矿化骨（p < 0.01）和更高的骨体积分数（p < 0.01）。与单独使用BMP-7或支架或两者联合相比，合成支架+BMP-7联合双膦酸盐改善了大鼠股骨临界尺寸缺损处的骨痂特性。
