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β-磷酸三钙(β-TCP)的基础研究与临床应用

Basic research and clinical application of beta-tricalcium phosphate (β-TCP).

作者信息

Tanaka T, Komaki H, Chazono M, Kitasato S, Kakuta A, Akiyama S, Marumo K

机构信息

Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, 2160 Shimo-Okamoto, 329-1193 Utsunomiya city, Tochigi, Japan; Department of Orthopaedic Surgery, Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minato-ku, Tokyo, Japan.

Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, 2160 Shimo-Okamoto, 329-1193 Utsunomiya city, Tochigi, Japan; Department of Orthopaedic Surgery, Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minato-ku, Tokyo, Japan.

出版信息

Morphologie. 2017 Sep;101(334):164-172. doi: 10.1016/j.morpho.2017.03.002. Epub 2017 Apr 24.

Abstract

The mechanism of bone substitute resorption involves two processes: solution-mediated and cell-mediated disintegration. In our previous animal studies, the main resorption process of beta-tricalcium phosphate (β-TCP) was considered to be cell-mediated disintegration by TRAP-positive cells. Thus, osteoclast-mediated resorption of β-TCP is important for enabling bone formation. We also report the results of treatment with β-TCP graft in patients since 1989. Two to three weeks after implantation, resorption of β-TCP occurred from the periphery, and then continued toward the center over time. Complete or nearly complete bone healing was achieved in most cases within a few years and was dependent upon the amount of implanted material, the patient's age, and the type of bone (cortical or cancellous). We have previously reported that an injectable complex of β-TCP granules and collagen supplemented with rhFGF-2 enabled cortical bone regeneration of rabbit tibiae. Based on the experimental results, we applied this technique to the patients with femoral and humeral fractures in elderly patients, and obtained bone union.

摘要

骨替代物吸收的机制涉及两个过程

溶液介导的分解和细胞介导的崩解。在我们之前的动物研究中,β-磷酸三钙(β-TCP)的主要吸收过程被认为是由TRAP阳性细胞介导的细胞崩解。因此,破骨细胞介导的β-TCP吸收对于促进骨形成很重要。我们还报告了自1989年以来β-TCP移植治疗患者的结果。植入后两到三周,β-TCP从周边开始吸收,然后随着时间的推移向中心持续吸收。在大多数情况下,几年内可实现完全或几乎完全的骨愈合,这取决于植入材料的数量、患者年龄和骨的类型(皮质骨或松质骨)。我们之前曾报道,一种含有rhFGF-2的β-TCP颗粒与胶原蛋白的可注射复合物能够实现兔胫骨皮质骨再生。基于实验结果,我们将该技术应用于老年股骨和肱骨骨折患者,实现了骨愈合。

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