1 Department of Trauma, Hand and Reconstructive Surgery, Johann Wolfgang Goethe-University , Frankfurt/Main, Germany .
2 Institut für Kardiovaskuläre Physiologie, Fachbereich Medizin der Goethe-Universität , Frankfurt am Main, Germany .
Tissue Eng Part A. 2016 Jan;22(1-2):133-41. doi: 10.1089/ten.TEA.2015.0030. Epub 2015 Dec 21.
The surgical treatment of large bone defects continues to pose a major challenge in modern trauma and orthopedic surgery. In this study we test the effectiveness of a tissue engineering approach, using three-dimensional (3D) β-tricalcium phosphate (β-TCP) scaffolding plus bone marrow-derived mononuclear cells (BM-MNCs), combined with a vascularized periosteal flap, in a rat femur critical size defect model.
Eighty rats were randomly allocated into four equal groups. Under general anesthesia, critical size defects were created on their femurs and were treated with (1) Vascularized periosteal flap alone, (2) Vascularized periosteal flap+β-TCP scaffolding, (3) Vascularized periosteal flap+β-TCP scaffolding+ligated vascular pedicle, and (4) Vascularized periosteal flap+β-TCP scaffolding+BM-MNCs. After 4 and 8 weeks animals were euthanized and the bone defects were harvested for analysis of new bone formation, vascularization, and strength using histology, immunohistology, micro-CT, and biomechanical testing, respectively.
Group 1: (P. flap) Increase in new bone formation and vascularization. Group 2: (P. flap+scaffold) Increase in new bone formation and vascularization. Group 3: (P. flap+scaffold+ligated vascular pedicle) No new bone formation and no vascularization. Group 4: (P. flap+scaffold+BM-MNCs) A significant (p < 0.05) increase was seen in new bone formation, vascularization, and strength in bones treated with flaps, scaffold, and BM-MNCs, when compared with the other treatment groups.
Combining a vascularized periosteal flap with tissue engineering approach (β-TCP scaffolding and BM-MNC) results in significantly improved bone healing in our rat femur critical size bone defect model.
在现代创伤和骨科手术中，大骨缺损的外科治疗仍然是一个主要挑战。在这项研究中，我们测试了一种组织工程方法的有效性，该方法使用三维（3D）β-磷酸三钙（β-TCP）支架加骨髓源性单核细胞（BM-MNC），结合血管化骨膜瓣，在大鼠股骨临界尺寸缺损模型中。
80 只大鼠被随机分为四组。在全身麻醉下，在它们的股骨上创建临界尺寸的缺损，并分别用（1）血管化骨膜瓣单独治疗，（2）血管化骨膜瓣+β-TCP 支架治疗，（3）血管化骨膜瓣+β-TCP 支架+结扎血管蒂治疗，（4）血管化骨膜瓣+β-TCP 支架+BM-MNC 治疗。4 周和 8 周后，处死动物，采集骨缺损标本进行分析，分别采用组织学、免疫组织化学、微 CT 和生物力学测试分析新骨形成、血管化和强度。
第 1 组：（P. flap）新骨形成和血管化增加。第 2 组：（P. flap+scaffold）新骨形成和血管化增加。第 3 组：（P. flap+scaffold+ligated vascular pedicle）无新骨形成，无血管化。第 4 组：（P. flap+scaffold+BM-MNCs）与其他治疗组相比，用皮瓣、支架和 BM-MNCs 治疗的骨中，新骨形成、血管化和强度显著增加（p<0.05）。
在我们的大鼠股骨临界尺寸骨缺损模型中，将血管化骨膜瓣与组织工程方法（β-TCP 支架和 BM-MNC）相结合，可显著改善骨愈合。
