Lim Z X H, Rai B, Tan T C, Ramruttun A K, Hui J H, Nurcombe V, Teoh S H, Cool S M
Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore.
Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore; Science and Maths Cluster, Singapore University of Technology & Design (SUTD), Singapore.
Bone Joint Res. 2019 Apr 2;8(3):107-117. doi: 10.1302/2046-3758.83.BJR-2018-0096.R1. eCollection 2019 Mar.
Long bone defects often require surgical intervention for functional restoration. The 'gold standard' treatment is autologous bone graft (ABG), usually from the patient's iliac crest. However, autograft is plagued by complications including limited supply, donor site morbidity, and the need for an additional surgery. Thus, alternative therapies are being actively investigated. Autologous bone marrow (BM) is considered as a candidate due to the presence of both endogenous reparative cells and growth factors. We aimed to compare the therapeutic potentials of autologous bone marrow aspirate (BMA) and ABG, which has not previously been done.
We compared the efficacy of coagulated autologous BMA and ABG for the repair of ulnar defects in New Zealand White rabbits. Segmental defects (14 mm) were filled with autologous clotted BM or morcellized autograft, and healing was assessed four and 12 weeks postoperatively. Harvested ulnas were subjected to radiological, micro-CT, histological, and mechanical analyses.
Comparable results were obtained with autologous BMA clot and ABG, except for the quantification of new bone by micro-CT. Significantly more bone was found in the ABG-treated ulnar defects than in those treated with autologous BMA clot. This is possibly due to the remnants of necrotic autograft fragments that persisted within the healing defects at week 12 post-surgery.
As similar treatment outcomes were achieved by the two strategies, the preferred treatment would be one that is associated with a lower risk of complications. Hence, these results demonstrate that coagulated BMA can be considered as an alternative autogenous therapy for long bone healing.: Z. X. H. Lim, B. Rai, T. C. Tan, A. K. Ramruttun, J. H. Hui, V. Nurcombe, S. H. Teoh, S. M. Cool. Autologous bone marrow clot as an alternative to autograft for bone defect healing. 2019;8:107-117. DOI: 10.1302/2046-3758.83.BJR-2018-0096.R1.
长骨缺损通常需要手术干预以恢复功能。“金标准”治疗方法是自体骨移植（ABG），通常取自患者的髂嵴。然而，自体移植存在诸多并发症，包括供应有限、供区发病以及需要额外的手术。因此，人们正在积极研究替代疗法。由于存在内源性修复细胞和生长因子，自体骨髓（BM）被视为一种候选方法。我们旨在比较自体骨髓抽吸物（BMA）和ABG的治疗潜力，此前尚未有人这样做过。
我们比较了凝固的自体BMA和ABG对新西兰白兔尺骨缺损修复的疗效。将节段性缺损（14毫米）用自体凝血BM或切碎的自体移植骨填充，并在术后4周和12周评估愈合情况。对收获的尺骨进行放射学、显微CT、组织学和力学分析。
自体BMA凝块和ABG获得了可比的结果，但显微CT对新骨的定量分析除外。在接受ABG治疗的尺骨缺损中发现的骨量明显多于接受自体BMA凝块治疗的缺损。这可能是由于术后12周时愈合缺损内持续存在坏死自体移植碎片残余。
由于两种策略取得了相似的治疗效果，首选的治疗方法应该是并发症风险较低的方法。因此，这些结果表明，凝固的BMA可被视为长骨愈合的一种替代自体疗法。：Z. X. H. Lim、B. Rai、T. C. Tan、A. K. Ramruttun、J. H. Hui、V. Nurcombe、S. H. Teoh、S. M. Cool。自体骨髓凝块作为骨缺损愈合自体移植的替代方法。2019年；8：107 - 117。DOI：10.1302/2046 - 3758.83.BJR - 2018 - 0096.R1。
