Department of Orthopedic Surgery, Areumcheil Hospital, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea.
J Orthop Surg Res. 2023 Aug 22;18(1):615. doi: 10.1186/s13018-023-04102-y.
The minipig has been used for research in various fields of medicine, even in orthopedics. Though previous studies have already suggested other methods to create osteoporotic bone, those methods had some disadvantages for taking time and efforts. Therefore, we aimed to generate osteoporotic proximal humerus and proximal femur of minipig using EDTA solution and validate their properties through dual energy X-ray absorptiometry (DEXA), micro-CT study, histological and biomechanical ways.
Six minipigs were used. Out of a total of 12 proximal humerus (PH) and 12 proximal femurs (PF), 6 PH and 6 PF were used as the decalcified group and the opposite side as the non-decalcified group. In vitro decalcification with Ca-chelating agents (0.5 M EDTA solution, pH 7.4) was used. Area BMD (aBMD) was measured using DEXA, Volumetric BMD (vBMD), and microstructure were measured using micro-CT. Universal testing machine was used to measure ultimate load to failure (ULTF). Each group was compared using two types of suture anchors (all-suture anchor, ASA, and conventional screw type anchor, CA).
There was a significant difference in aBMD and cortical thickness (aBMD: decalcified, 0.433 ± 0.073 g/cm, undecalcified, 0.962 ± 0.123 g/cm, p < 0.001; cortical thickness: decalcified, 0.33 ± 0.34 mm, undecalcified, 1.61 ± 0.45 mm, p < 0.001). In the case of ASA, the ULTF was significantly lower in the decalcified group (decalcified: 176.6 ± 74.2 N, non-decalcified: 307.7 ± 116.5 N, p = 0.003). In the case of CA, there was no significant difference (decalcified: 265.1 ± 96.0 N, undecalcified: 289.4 ± 114.5 N, p = 0.578).
We demonstrated that decalcification with EDTA solution significantly decreased aBMD, vBMD, and cortical thickness. Decalcified minipig bone using EDTA resulted in similar biomechanical properties as osteoporotic human bone with respect to anchor pull-out.
小型猪已被用于医学的各个领域的研究，甚至在骨科领域也有应用。虽然之前的研究已经提出了其他制造骨质疏松骨的方法，但这些方法需要花费大量的时间和精力。因此，我们旨在使用 EDTA 溶液生成小型猪的骨质疏松性肱骨头和股骨头，并通过双能 X 射线吸收法（DEXA）、微 CT 研究、组织学和生物力学方法来验证其特性。
使用了 6 只小型猪。总共 12 个肱骨头（PH）和 12 个股骨头（PF）中，有 6 个 PH 和 6 个 PF 被用作脱钙组，另一侧则为非脱钙组。使用 Ca 螯合剂（0.5 M EDTA 溶液，pH7.4）进行体外脱钙。使用 DEXA 测量面积骨密度（aBMD），使用微 CT 测量体积骨密度（vBMD）和微观结构。使用万能试验机测量最大失效负载（ULTF）。使用两种类型的缝线锚（全缝线锚，ASA 和传统螺钉型锚，CA）对每组进行比较。
aBMD 和皮质厚度有显著差异（aBMD：脱钙组为 0.433±0.073 g/cm，未脱钙组为 0.962±0.123 g/cm，p<0.001；皮质厚度：脱钙组为 0.33±0.34mm，未脱钙组为 1.61±0.45mm，p<0.001）。在使用 ASA 的情况下，脱钙组的 ULTF 明显较低（脱钙组：176.6±74.2 N，未脱钙组：307.7±116.5 N，p=0.003）。在使用 CA 的情况下，没有显著差异（脱钙组：265.1±96.0 N，未脱钙组：289.4±114.5 N，p=0.578）。
我们证明了 EDTA 溶液脱钙可显著降低 aBMD、vBMD 和皮质厚度。使用 EDTA 对小型猪骨进行脱钙处理，在锚钉拔出方面，可使生物力学特性类似于骨质疏松性人骨。
