Orthopedics Institute of Chinese PLA, 89th Hospital, 256 Beigongxijie, Weifang, Shandong Province, People's Republic of China.
J Biomed Mater Res B Appl Biomater. 2018 Aug;106(6):2148-2156. doi: 10.1002/jbm.b.34018. Epub 2017 Oct 11.
Various synthetic bone substitutes are not suitable for reconstructing critical-size bone defects. This study tested whether a bioglass-β-tricalcium phosphate (β-TCP) monoblock is effective for repairing critical-size segmental bone defects if combined with a vascularized periosteal flap and bone morphogenetic protein (BMP)-2. A femoral osteotomy with a gap size of 20 mm was created and stabilized using a plate in 40 rabbits.The defect was left untreated (group A) or repaired using a monoblock (group B), a monoblock with a vascularized periosteal flap (group C), or a monoblock with a vascularized periosteal flap and BMP-2 (group D). Bone regeneration, vascularization and monoblock degradation were analyzed after four and eight weeks using x-ray, hematoxylin-eosin, CD34 immunohistochemical and Masson's trichrome staining observation and histometric evaluation. The radiographic grading score showed a time-dependent increase from weeks 4 to 8. At 8-week postoperative, the total new regenerated bone in groups C and D was 20.0 ± 0.3 and 55.5 ± 8.0 mm , respectively, which was significantly greater than in group B. Conversely, group D showed less residual monoblock than did group C. An increase in microvessel density was also observed in groups C and D compared with group B at 4 and 8 weeks postoperative, respectively. This study suggests that bioglass-β-TCP monoblock alone exhibits poor potential to repair a 20-mm femoral defect. However, supplementation with a vascularized periosteal flap and BMP-2 led to effective vascularization and reliable bone regeneration throughout the monoblock, with concordant material degradation in a timely manner. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2148-2156, 2018.
各种合成骨替代品并不适合重建临界尺寸的骨缺损。本研究测试了在结合血管化骨膜瓣和骨形态发生蛋白（BMP）-2 的情况下，生物玻璃-β-磷酸三钙（β-TCP）单体是否可有效修复临界尺寸的节段性骨缺损。在 40 只兔子中，通过钢板稳定地创建并稳定了一个 20mm 间隙大小的股骨干切开术。缺陷未处理（A 组）或使用单体（B 组）、带血管化骨膜瓣的单体（C 组）或带血管化骨膜瓣和 BMP-2 的单体（D 组）进行修复。使用 X 射线、苏木精-伊红、CD34 免疫组织化学和 Masson 三色染色观察和组织计量评估，在 4 周和 8 周后分析骨再生、血管生成和单体降解情况。放射学分级评分显示从第 4 周到第 8 周呈时间依赖性增加。在术后 8 周时，C 组和 D 组的总新生再生骨分别为 20.0±0.3 和 55.5±8.0mm，明显大于 B 组。相反，D 组的单体残留量明显少于 C 组。与 B 组相比，C 组和 D 组在术后 4 周和 8 周时微血管密度也分别增加。本研究表明，生物玻璃-β-TCP 单体本身修复 20mm 股骨干缺损的潜力较差。然而，补充血管化骨膜瓣和 BMP-2 可导致单体有效血管化和可靠的骨再生，同时及时进行一致的材料降解。©2017 Wiley Periodicals，Inc. J 生物材料研究杂志 B：应用生物材料，106B：2148-2156，2018。
