Department of Orthopaedic and Traumatology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Private Bandırma Royal Hospital, Balıkesir, Turkey.
J Orthop Surg Res. 2020 Dec 11;15(1):601. doi: 10.1186/s13018-020-02142-2.
Extensive bone defects remain a therapeutic challenge necessitating alternative surgical approaches with better outcomes. Can increase the effectiveness of PRP or EGF treatment in surgical treatment of large bone defects with Masquelet technique? Aim of this study examined potential therapeutic benefits of the Masquelet technique with induced membranes in combination with platelet-rich plasma (PRP) or epidermal growth factor (EGF) in a rat model of segmental femur defect.
Three groups each consisting of 20 Sprague-Dawley rats were defined as follows: EGF group, PRP group, and control group. A femoral bone defect was created and filled with antibiotic embedded polymethyl methacrylate. Half of the animals in each group were sacrificed at week 6 and the pseudo-membranes formed were analyzed. In the remaining half, the cement was removed and the space was filled with autograft. After another 6 weeks, the structures formed were examined radiologically, histologically, and biochemically.
At week 6, both PRP and EGF groups had significantly higher membrane CD31, TGF-beta, and VEGF levels than controls. At week 12, when compared to controls, PRP and EGF groups had significantly higher membrane CD31 levels and the PRP group had significantly higher membrane TGF levels. Regarding bone tissue levels, PRP and EGF groups had significantly higher VEGF levels and the EGF group had significantly higher BMP levels. In addition, PRP and EGF groups had higher radiological scores than controls. However, the two experimental groups did not differ with respect to any parameter tested in this study.
Both PRP and EGF seem to be associated with histological, biochemical, and radiological improvements in experimental rat model of Masquelet technique, warranting in further clinical studies.
Level 5.
广泛的骨缺损仍然是一个治疗挑战，需要采用更好结果的替代手术方法。Masquelet 技术联合使用富血小板血浆（PRP）或表皮生长因子（EGF）能否增加 PRP 或 EGF 治疗在外科治疗大骨缺损中的效果？本研究旨在探讨诱导膜结合 PRP 或 EGF 在 Masquelet 技术治疗节段性股骨缺损的大鼠模型中的潜在治疗益处。
将 20 只 Sprague-Dawley 大鼠分为 3 组，每组 20 只，分别为：EGF 组、PRP 组和对照组。每组的一半动物在第 6 周时被处死，并分析形成的假性膜。在其余一半动物中，去除水泥并用自体移植物填充。6 周后，通过影像学、组织学和生物化学方法检查形成的结构。
第 6 周时，PRP 组和 EGF 组的膜 CD31、TGF-β和 VEGF 水平明显高于对照组。第 12 周时，与对照组相比，PRP 组和 EGF 组的膜 CD31 水平明显升高，PRP 组的膜 TGF-β水平明显升高。在骨组织水平方面，PRP 组和 EGF 组的 VEGF 水平明显升高，EGF 组的 BMP 水平明显升高。此外，PRP 组和 EGF 组的影像学评分均高于对照组。然而，在本研究测试的所有参数方面，这两个实验组之间没有差异。
PRP 和 EGF 似乎都与 Masquelet 技术实验大鼠模型的组织学、生化和影像学改善相关，值得进一步的临床研究。
5 级。
