Šponer Pavel, Filip Stanislav, Kučera Tomáš, Brtková Jindra, Urban Karel, Palička Vladimír, Kočí Zuzana, Syka Michael, Bezrouk Aleš, Syková Eva
Department of Orthopaedic Surgery, Charles University in Prague, Faculty of Medicine in Hradec Králové, Šimkova 870, 500 38 Hradec Králové, Czech Republic.
Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine in Hradec Králové, Šimkova 870, 500 38 Hradec Králové, Czech Republic.
Biomed Res Int. 2016;2016:2076061. doi: 10.1155/2016/2076061. Epub 2016 Apr 7.
The purpose of this prospective controlled study was to compare healing quality following the implantation of ultraporous β-tricalcium phosphate, containing either expanded autologous mesenchymal stromal cells (trial group, 9 patients) or β-tricalcium phosphate alone (control group, 9 patients), into femoral defects during revision total hip arthroplasty. Both groups were assessed using the Harris Hip Score, radiography, and DEXA scanning at 6 weeks and 3, 6, and 12 months postoperatively. A significant difference in the bone defect healing was observed between both groups of patients (P < 0.05). In the trial group, trabecular remodeling was found in all nine patients and in the control group, in 1 patient only. Whereas, over the 12-month follow-up period, no significant difference was observed between both groups of patients in terms of the resorption of β-tricalcium phosphate, the significant differences were documented in the presence of radiolucency and bone trabeculation through the defect (P < 0.05). Using autologous mesenchymal stromal cells combined with a β-tricalcium phosphate scaffold is a feasible, safe, and effective approach for management of bone defects with compromised microenvironment. The clinical trial was registered at the EU Clinical Trials Register before patient recruitment has begun (EudraCT number 2012-005599-33).
这项前瞻性对照研究的目的是比较在翻修全髋关节置换术中,将含有扩增自体间充质基质细胞的超多孔β-磷酸三钙(试验组,9例患者)或单独的β-磷酸三钙(对照组,9例患者)植入股骨缺损后的愈合质量。两组患者均在术后6周以及3、6和12个月时使用Harris髋关节评分、X线摄影和双能X线吸收测定法进行评估。观察到两组患者的骨缺损愈合存在显著差异(P<0.05)。在试验组中,所有9例患者均发现小梁重塑,而在对照组中,仅1例患者出现小梁重塑。然而,在12个月的随访期内,两组患者在β-磷酸三钙吸收方面未观察到显著差异,但在缺损处的透亮区和骨小梁形成方面记录到了显著差异(P<0.05)。使用自体间充质基质细胞联合β-磷酸三钙支架是一种用于处理微环境受损的骨缺损的可行、安全且有效的方法。该临床试验在患者招募开始前已在欧盟临床试验注册中心注册(欧盟临床试验注册号2012-005599-33)。