Yılmaz Orkun, Özmeriç Ahmet, Alemdaroğlu Kadir Bahadır, Celepli Pınar, Hücümenoğlu Sema, Şahin Özgür
Ankara Training and Research Hospital, Department of Orthopaedics, Turkey.
Ankara Training and Research Hospital, Department of Orthopaedics, Turkey.
Injury. 2018 Aug;49(8):1497-1503. doi: 10.1016/j.injury.2018.06.011. Epub 2018 Jun 8.
The aim of the study was to test if the addition of CGF to the Masquelet technique contributes to the quality of the membrane formed surrounding the polymethylmethacrylate (PMMA), in terms of inflammation, proliferation and vasculazition in the Masquelet technique in the early and late phases in a rabbit model.
A critical bone defect of 15 mm was created in radius diaphysis, leaving 3 cm of intact bone to the joint. To mimic the Masquelet technique and to increase stability, a 6-hole 1.5 mm plate with two screws was applied, although it was initialy stable because of the inherently fixed ulna and radius both proximally and distally in the rabbits. Group 1 and Group 3, were soleley treated with the Masquelet technique as control groups, and were sacrificed at 3 and 6 weeks, respectively. Group 2 and Group 4, were treated with the Masquelet technique + CGF prepared from the rabbit blood groups, and were sacrificed at 3 and 6 weeks, respectively. The groups were compared histopathologically and immunohistochemically, in respect of the means of thickness of the membrane and ratio of elastic fibers, membrane vascularization (CD31), inflammation (MAC387), proliferation (Ki67), and presence of stem cells (STRO-1).
Thickness of the membrane and CD31 values were significantly higher in Group 4 than Group 3 (p = 0.004 for both). MAC387 was statistically significantly higher in Group 2 compared to Group 1 and Group 4 compared to Group 3 (p = 0.04 for both). Ki67 was significantly higher in Group 2 compared to Group 1 and Group 4 compared to Group 3 (p = 0.05 and p = 0.006, respectively). Proliferation in the membrane was statistically significantly higher in Group 2 compared to Group 1 (p = 0.05). Likewise, the proliferation index of Group 4 was statistically significantly higher than Group 3 (p = 0.06). STRO-1 was significantly higher in Group 2 compared to Group 1 (p = 0036).
The addition of CGF to the Masquelet technique contributes to the quality of the membrane formed, in respect of inducing inflammation and proliferation, maintaining vascularization on large diaphyseal bone defects, and increasing the number of stem cells.
本研究的目的是在兔模型中，测试在Masquelet技术中添加富浓缩生长因子（CGF）是否有助于提高围绕聚甲基丙烯酸甲酯（PMMA）形成的膜的质量，包括在Masquelet技术早期和晚期的炎症、增殖和血管形成方面。
在桡骨干制造一个15毫米的临界骨缺损，距关节保留3厘米完整骨。为模拟Masquelet技术并增加稳定性，应用一块带两颗螺钉的6孔1.5毫米钢板，尽管由于兔尺骨和桡骨在近端和远端固有固定，初始时是稳定的。第1组和第3组仅采用Masquelet技术作为对照组，分别在3周和6周时处死。第2组和第4组采用Masquelet技术+从兔血制备的CGF进行治疗，也分别在3周和6周时处死。对各组进行组织病理学和免疫组织化学比较，比较指标包括膜的厚度、弹性纤维比例、膜血管形成（CD31）、炎症（MAC387）、增殖（Ki67）以及干细胞存在情况（STRO-1）。
第4组的膜厚度和CD31值显著高于第3组（两者p均 = 0.004）。第2组的MAC387在统计学上显著高于第1组，第4组显著高于第3组（两者p均 = 0.04）。第2组的Ki67显著高于第1组，第4组显著高于第3组（分别为p =
