National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, The Third Military Medical University, Chongqing, China.
Center of Regenerative and Reconstructive Engineering Technology in Chongqing City, Chongqing, China.
Cell Transplant. 2020 Jan-Dec;29:963689720940722. doi: 10.1177/0963689720940722.
The treatment of bone defects has always been a challenge for orthopedic surgeons. The development of tissue engineering technology provides a novel method for repairing bone defects and has been used in animal experiments and clinical trials. However, there are few clinical studies on comparing the long-term outcomes of tissue-engineered bones (TEBs) and other bone grafts in treating bone defects, and the long-term efficiency of TEBs remains controversial. Therefore, a study designed by us was aimed to compare the long-term efficacy and safety of individual tissue-engineered bones (iTEBs) and allogeneic bone granules (ABGs) in treating bone defects caused by curettage of benign bone tumors and tumor-like lesions. From September 2003 to November 2009, 48 patients who received tumor curettage and bone grafting were analyzed with a mean follow-up of 122 mo (range 60 to 173 mo). Based on implant style, patients were divided into groups of iTEBs ( = 23) and ABGs ( = 25). Postoperatively, the healing time, healing quality, incidence of complications, and functional scores were compared between the two groups. The Musculoskeletal Tumor Society functional evaluation system and Activities of Daily Living Scale scores were significantly improved in both groups with no significant difference. The average healing time of ABGs was longer than that of iTEBs ( < 0.05). At the final follow-up, iTEBs had a better performance in the bone healing quality evaluated by modified Neer classification ( < 0.05). In the group of iTEBs, the complication and reoperation rate was lower than that in the group of ABGs, with no tumorigenesis or immune rejection observed. In summary, for treating bone defects caused by tumor curettage, iTEBs were safe, effective, and tagged with more rapid healing speed, better healing outcome, and lower complication and reoperation rate, in comparison with ABGs.
治疗骨缺损一直是骨科医生面临的挑战。组织工程技术的发展为修复骨缺损提供了一种新方法，已应用于动物实验和临床试验。然而，比较组织工程骨（TEB）和其他骨移植物治疗骨缺损的长期结果的临床研究较少，TEB 的长期效果仍存在争议。因此，我们设计了一项研究，旨在比较个体化组织工程骨（iTEB）和同种异体骨粒（ABG）治疗良性骨肿瘤和肿瘤样病变刮除术后骨缺损的长期疗效和安全性。2003 年 9 月至 2009 年 11 月，分析了 48 例接受肿瘤刮除和植骨的患者，平均随访 122 个月（范围 60-173 个月）。根据植入物类型，将患者分为 iTEB 组（n=23）和 ABG 组（n=25）。术后比较两组患者的愈合时间、愈合质量、并发症发生率和功能评分。两组患者的肌肉骨骼肿瘤学会功能评估系统和日常生活活动量表评分均显著提高，差异无统计学意义。ABG 的平均愈合时间长于 iTEB（ < 0.05）。末次随访时，iTEB 组改良 Neer 分级评估的骨愈合质量更好（ < 0.05）。在 iTEB 组中，并发症和再次手术率低于 ABG 组，未观察到肿瘤形成或免疫排斥反应。综上所述，与 ABG 相比，iTEB 治疗肿瘤刮除术后骨缺损安全、有效，且具有愈合速度更快、愈合效果更好、并发症和再次手术率更低的特点。
