Mermerkaya Musa Uğur, Doral Mahmut Nedim, Karaaslan Fatih, Huri Gazi, Karacavuş Seyhan, Kaymaz Burak, Alkan Erkan
Department of Orthopaedics and Traumatology, Medical School, Bozok University, Yozgat, Turkey.
Department of Orthopaedics and Traumatology, Medical School, Hacettepe University, Ankara, Turkey.
J Orthop Surg Res. 2016 May 3;11(1):57. doi: 10.1186/s13018-016-0393-y.
An unfavorable condition for bone healing is the presence of bone defects. Under such conditions, a material can play a role to cover fractured or defective bone. Technological advances now allow for the use of such material. Hyalonect(®) (Fidia Advanced Biopolymers SLR, Italy), a novel membrane comprising knitted fibers of esterified hyaluronan (HYAFF11) can be used to cover fractured or grafted bone and can also serve as a scaffold to keep osteoprogenitor cells in place. The aim of this study was to compare osteoblastic activity by the use of scintigraphic methods in defective rabbit tibias during early-phase bone healing with or without a hyaluronan-based mesh.
Two groups (A and B) of New Zealand albino rabbits were used; each group included 10 animals. Operations on all rabbits were performed under general anesthesia. We also resected 10-mm bone segments from each animal's tibial diaphysis. After resection, tibias with defects were fixed using Kirschner wires. In group A, no hyaluronan-based mesh was used. In group B, tibial segmental defects were enclosed with a hyaluronan-based mesh. The rabbits were followed up for 4 weeks postoperatively, after which bone scintigraphic studies were performed on each animal to detect and compare osteoblastic activity.
The mean count in the fracture side of the hyaluronan-based mesh group was significantly higher compared to that of the group A (p = 0.019). However, there was no significant difference between group B and control rabbits with respect to the mean count on the intact bone side (p = 0.437). The bone defect (fracture)/intact bone mean count ratio was significantly higher in group B compared to group A (p = 0.008).
A hyaluronan-based mesh plays a role in promoting osteoblastic activity. Hyalonect(®) is suitable for restoring tissue continuity whenever the periosteal membrane is structurally impaired or inadequate. Our results demonstrated that, during early-phase bone healing, osteoblastic activity was increased in bone defect sites when a hyaluronan-based mesh was also used. The most important aspect of this study concerns its scintigraphy-based design. This study is the first to use a scintigraphic method to demonstrate the effectiveness of hyaluronic acid-based material for bone healing.
骨缺损的存在是不利于骨愈合的一个因素。在这种情况下，一种材料可以起到覆盖骨折或有缺损的骨的作用。现在技术的进步使得这种材料的使用成为可能。Hyalonect(®)（意大利菲迪亚先进生物聚合物公司）是一种新型的膜，由酯化透明质酸（HYAFF11）的编织纤维组成，可用于覆盖骨折或移植的骨，也可作为支架将骨祖细胞固定在原位。本研究的目的是通过闪烁扫描法比较在早期骨愈合过程中，有或没有基于透明质酸的网片的情况下，兔胫骨缺损处的成骨细胞活性。
使用两组（A组和B组）新西兰白化兔；每组包括10只动物。所有兔子的手术均在全身麻醉下进行。我们还从每只动物的胫骨干中切除10毫米的骨段。切除后，用克氏针固定有缺损的胫骨。A组未使用基于透明质酸的网片。B组用基于透明质酸的网片封闭胫骨节段性缺损。术后对兔子进行4周的随访，之后对每只动物进行骨闪烁扫描研究，以检测和比较成骨细胞活性。
与A组相比，基于透明质酸的网片组骨折侧的平均计数显著更高（p = 0.019）。然而，B组与对照兔在完整骨侧的平均计数方面没有显著差异（p = 0.437）。B组的骨缺损（骨折）/完整骨平均计数比值显著高于A组（p = 0.008）。
基于透明质酸的网片在促进成骨细胞活性方面发挥作用。每当骨膜结构受损或不足时，Hyalonect(®)适用于恢复组织连续性。我们的结果表明，在早期骨愈合过程中，当使用基于透明质酸的网片时，骨缺损部位的成骨细胞活性增加。本研究最重要的方面涉及其基于闪烁扫描的设计。本研究是首次使用闪烁扫描法证明基于透明质酸的材料对骨愈合的有效性。
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