Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Department of Biology, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
J Biomed Mater Res B Appl Biomater. 2018 Feb;106(2):649-658. doi: 10.1002/jbm.b.33870. Epub 2017 Mar 9.
Bone defects created after curettage of benign bone tumors are customarily filled with solid poly(methyl methacrylate) (PMMA) or other bone substitutes. In this study, we depicted a porous PMMA-based cement (produced by mixing sodium bicarbonate and citric acid) and evaluated the prospect of its clinic application. Cement samples were characterized by high-performance liquid chromatography (HPLC) coupled to mass spectrometry and its cytotoxicity evaluated in fibroblast cultures. Implantation in rabbits allowed the histologic analysis of bone, kidneys, and liver for toxicity and coagulation tests, and MRI images for hemostasis evaluation. Osseointegration was analyzed through radiography, microtomography (micro-CT), SEM, and histology of sheep specimens. Rabbit specimens were analyzed 1, 4, and 7 days after implantation of porous or solid bone cement in 6.0 mm femoral defects. Sheep specimens were analyzed 3 and 6 months after implantation or not of porous or solid cement in 15.0 mm subchondral tibial defects. The production process did not release any detectable toxic substance but slightly reduced fibroblast proliferation in vitro. Until 7 days after surgery, no local or systemic alterations could be detected in histology, or hematoma formation in histology or MRI. Sheep implants showed 6 mm linear ingrowth from the bone-cement interface and 20% bone ingrowth considering the whole defect area. Radiography, micro-CT, SEM, and histology confirmed these findings. We conclude that our porous PMMA-based cement is an attractive alternative treatment for bone defect filling that combines osseointegration and early weight bearing. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 649-658, 2018.
良性骨肿瘤刮除术后形成的骨缺损通常用固体聚甲基丙烯酸甲酯（PMMA）或其他骨替代物填充。在本研究中，我们描述了一种多孔 PMMA 基水泥（通过混合碳酸氢钠和柠檬酸制成），并评估了其临床应用前景。通过高效液相色谱（HPLC）与质谱联用对水泥样本进行了表征，并在成纤维细胞培养中评估了其细胞毒性。将植入物植入兔子体内，可进行骨、肾和肝的组织学分析，以评估毒性和凝血试验，以及 MRI 图像以评估止血效果。通过射线照相、微断层扫描（micro-CT）、SEM 和绵羊标本的组织学分析来分析骨整合。在 6.0mm 股骨缺损中，分别在植入多孔或实心骨水泥后 1、4 和 7 天，对兔标本进行分析。在 3 和 6 个月后，在不植入多孔或实心水泥的情况下，在 15.0mm 软骨下胫骨缺损中，对绵羊标本进行分析。该生产过程没有释放任何可检测的有毒物质，但略微降低了体外成纤维细胞的增殖。在组织学或 MRI 中，术后 7 天内，未发现局部或全身改变。绵羊植入物显示从骨水泥界面有 6mm 线性生长，考虑到整个缺损区域，有 20%的骨生长。射线照相、micro-CT、SEM 和组织学证实了这些发现。我们得出结论，我们的多孔 PMMA 基水泥是一种有吸引力的替代治疗骨缺损填充的方法，它结合了骨整合和早期负重。2017 年 Wiley 期刊公司。J 生物医学材料研究杂志 B：应用生物材料，106B：649-658，2018 年。
