Freischmidt Holger, Armbruster Jonas, Rothhaas Catharina, Titze Nadine, Guehring Thorsten, Nurjadi Dennis, Sonntag Robert, Schmidmaier Gerhard, Grützner Paul Alfred, Helbig Lars
Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, 67071 Ludwigshafen am Rhein, Germany.
Trauma Centre, Hospital Paulinenhilfe Stuttgart at Tübingen University Hospital, Rosenbergstr. 38, 70176 Stuttgart, Germany.
Materials (Basel). 2022 Feb 24;15(5):1697. doi: 10.3390/ma15051697.
The treatment of infected and non-infected non-unions remains a major challenge in trauma surgery. Due to the limited availability of autologous bone grafts and the need for local anti-infective treatment, bone substitutes have been the focus of tissue engineering for years. In this context, bioactive glasses are promising, especially regarding their anti-infective potential, which could reduce the need for local and systemic treatment with conventional antibiotics. The aim of this study was to investigate the osteoinductive and osteoconductive effects, as well as the anti-infectious potential, of S53P4 using a standardized non-union model, which had not been investigated previously. Using an already established sequential animal model in infected and non-infected rat femora, we were able to investigate bioactive glass S53P4 under realistic non-union conditions regarding its osteoinductive, osteoconductive and anti-infective potential with the use of µCT scans, biomechanical testing and histological, as well as microbiological, analysis. Although S53P4 did not lead to a stable union in the non-infected or the infected setting, µCT analysis revealed an osteoinductive effect of S53P4 under non-infected conditions, which was diminished under infected conditions. The osteoconductive effect of S53P4 remained almost negligible in histological analysis, even 8 weeks after treatment. Additionally, the expected anti-infective effect could not be demonstrated. Our data suggested that S53P4 should not be used in infected non-unions, especially in those with large bone defects.
感染性和非感染性骨不连的治疗仍是创伤外科的一项重大挑战。由于自体骨移植的可用性有限以及局部抗感染治疗的需求，骨替代物多年来一直是组织工程的重点。在这种背景下，生物活性玻璃很有前景，特别是考虑到其抗感染潜力，这可能会减少使用传统抗生素进行局部和全身治疗的需求。本研究的目的是使用标准化的骨不连模型研究S53P4的骨诱导和骨传导作用以及抗感染潜力，此前尚未对该模型进行过研究。利用已建立的感染和未感染大鼠股骨的序贯动物模型，我们能够在现实的骨不连条件下，通过使用μCT扫描、生物力学测试以及组织学和微生物学分析，研究生物活性玻璃S53P4的骨诱导、骨传导和抗感染潜力。尽管S53P4在未感染或感染情况下均未导致稳定的骨愈合，但μCT分析显示S53P4在未感染条件下具有骨诱导作用，而在感染条件下这种作用减弱。即使在治疗8周后，S53P4在组织学分析中的骨传导作用仍然几乎可以忽略不计。此外，预期的抗感染效果也未能得到证实。我们的数据表明，S53P4不应应用于感染性骨不连，尤其是那些存在大的骨缺损的情况。
