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一种具有成骨诱导性和可生物降解性的髓内植入物可加速雄性大鼠的骨愈合并减轻骨搬运的并发症。

An osteoinductive and biodegradable intramedullary implant accelerates bone healing and mitigates complications of bone transport in male rats.

机构信息

Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA, 94305, USA.

Department of Mechanical Engineering, School of Engineering, Stanford University, Stanford, CA, 94305, USA.

出版信息

Nat Commun. 2023 Jul 24;14(1):4455. doi: 10.1038/s41467-023-40149-5.

Abstract

Bone transport is a surgery-driven procedure for the treatment of large bone defects. However, challenging complications include prolonged consolidation, docking site nonunion and pin tract infection. Here, we develop an osteoinductive and biodegradable intramedullary implant by a hybrid tissue engineering construct technique to enable sustained delivery of bone morphogenetic protein-2 as an adjunctive therapy. In a male rat bone transport model, the eluting bone morphogenetic protein-2 from the implants accelerates bone formation and remodeling, leading to early bony fusion as shown by imaging, mechanical testing, histological analysis, and microarray assays. Moreover, no pin tract infection but tight osseointegration are observed. In contrast, conventional treatments show higher proportion of docking site nonunion and pin tract infection. The findings of this study demonstrate that the novel intramedullary implant holds great promise for advancing bone transport techniques by promoting bone regeneration and reducing complications in the treatment of bone defects.

摘要

骨搬运术是一种治疗大段骨缺损的手术方法。然而,其面临的挑战包括延长愈合时间、会师点不愈合和钢针道感染等并发症。在此,我们采用组织工程构建技术开发了一种具有骨诱导和可生物降解性的髓内植入物,以实现骨形态发生蛋白-2 的持续释放,作为辅助治疗手段。在雄性大鼠骨搬运模型中,从植入物中洗脱的骨形态发生蛋白-2 可加速骨形成和重塑,影像学、力学测试、组织学分析和微阵列检测结果表明可实现早期骨性融合。此外,观察到没有钢针道感染,但存在紧密的骨整合。相比之下,传统治疗方法显示出更高比例的会师点不愈合和钢针道感染。本研究结果表明,新型髓内植入物通过促进骨再生和减少骨缺损治疗中的并发症,为推进骨搬运技术提供了广阔的前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c9d/10366099/db674b307c99/41467_2023_40149_Fig1_HTML.jpg

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