Municipal Hospital Affiliated to Medical School of Taizhou University, Taizhou, China.
Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
J Orthop Surg Res. 2019 Jun 26;14(1):192. doi: 10.1186/s13018-019-1235-5.
Large segmental bone defects can be repaired using the Masquelet technique in conjunction with autologous cancellous bone (ACB). However, ACB harvesting is severely restricted. α-calcium sulfate hemihydrate (α-CSH) is an outstanding bone substitute due to its easy availability, excellent biocompatibility, biodegradability, and osteoconductivity. However, the resorption rate of α-CSH is too fast to match the rate of new bone formation. The objective of this study was to investigate the bone repair capacity of the Masquelet technique in conjunction with isolated α-CSH or an α-CSH/ACB mix in a rabbit critical-sized defect model.
The rabbits (n = 28) were randomized into four groups: sham, isolated α-CSH, α-CSH/ACB mix, and isolated ACB group. A 15-mm critical-sized defect was established in the left radius, followed by filling with polymethyl methacrylate spacer. Six weeks after the first operation, the spacers were removed and the membranous tubes were grafted with isolated α-CSH, isolated ACB, α-CSH/ACB mix, or none. Twelve weeks later, the outcomes were evaluated by manual assessment, radiography, and spiral-CT. The histopathological and morphological changes were examined by H&E staining. The levels of alkaline phosphatase and osteocalcin were analyzed by immunohistochemistry and immunofluorescence staining.
Our results suggest that the bone repair capacity of the α-CSH/ACB mix group was similar to the isolated ACB group, while the isolated α-CSH group was significantly decreased compared to the isolated ACB group.
These results highlighted a promising strategy in the healing of large segmental bone defect with the Masquelet technique in conjunction with an α-CSH/ACB mix (1:1, w/w) as they possessed the combined effects of sufficient supply and low resorption.
使用 Masquelet 技术结合自体松质骨（ACB）可以修复大段骨缺损。然而，ACB 的采集受到严重限制。α-半水硫酸钙（α-CSH）是一种出色的骨替代物，具有易得、良好的生物相容性、可生物降解性和骨传导性。然而，α-CSH 的吸收速度太快，无法与新骨形成的速度相匹配。本研究旨在探讨 Masquelet 技术联合单独使用α-CSH 或α-CSH/ACB 混合物在兔临界尺寸缺损模型中的骨修复能力。
将兔子（n = 28）随机分为四组：假手术组、单独α-CSH 组、α-CSH/ACB 混合物组和单独 ACB 组。在左侧桡骨建立 15mm 的临界尺寸缺损，然后用聚甲基丙烯酸甲酯间隔物填充。第一次手术后 6 周，取出间隔物，用膜管状物移植单独的α-CSH、单独的 ACB、α-CSH/ACB 混合物或不移植。12 周后，通过手动评估、放射学和螺旋 CT 评估结果。通过 H&E 染色检查组织病理学和形态学变化。通过免疫组化和免疫荧光染色分析碱性磷酸酶和骨钙素的水平。
我们的结果表明，α-CSH/ACB 混合物组的骨修复能力与单独 ACB 组相似，而单独α-CSH 组与单独 ACB 组相比明显降低。
这些结果突出了 Masquelet 技术联合α-CSH/ACB 混合物（1:1，w/w）在治疗大段骨缺损方面的一种有前途的策略，因为它们具有充足供应和低吸收的综合作用。
