Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre, Madrid, España; Instituto de Investigación I+12, Madrid, España.
Instituto de Investigación I+12, Madrid, España; Departamento de Química en Ciencias Farmacéuticas, Universidad Complutense de Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, España.
Acta Biomater. 2024 May;180:104-114. doi: 10.1016/j.actbio.2024.04.005. Epub 2024 Apr 5.
In the field of orthopedic surgery, there is an increasing need for the development of bone replacement materials for the treatment of bone defects. One of the main focuses of biomaterials engineering are advanced bioceramics like mesoporous bioactive glasses (MBG´s). The present study compared the new bone formation after 12 weeks of implantation of MBG scaffolds with composition 82,5SiO-10CaO-5PO-x 2.5SrO alone (MBGA), enriched with osteostatin, an osteoinductive peptide, (MBGO) or enriched with bone marrow aspirate (MBGB) in a long bone critical defect in radius bone of adult New Zealand rabbits. New bone formation from the MBG scaffold groups was compared to the gold standard defect filled with iliac crest autograft and to the unfilled defect. Radiographic follow-up was performed at 2, 6, and 12 weeks, and microCT and histologic examination were performed at 12 weeks. X-Ray study showed the highest bone formation scores in the group with the defect filled with autograft, followed by the MBGB group, in addition, the microCT study showed that bone within defect scores (BV/TV) were higher in the MBGO group. This difference could be explained by the higher density of newly formed bone in the osteostatin enriched MBG scaffold group. Therefore, MBG scaffold alone and enriched with osteostatin or bone marrow aspirate increase bone formation compared to defect unfilled, being higher in the osteostatin group. The present results showed the potential to treat critical bone defects by combining MBGs with osteogenic peptides such as osteostatin, with good prospects for translation into clinical practice. STATEMENT OF SIGNIFICANCE: Treatment of bone defects without the capacity for self-repair is a global problem in the field of Orthopedic Surgery, as evidenced by the fact that in the U.S alone it affects approximately 100,000 patients per year. The gold standard of treatment in these cases is the autograft, but its use has limitations both in the amount of graft to be obtained and in the morbidity produced in the donor site. In the field of materials engineering, there is a growing interest in the development of a bone substitute equivalent. Mesoporous bioactive glass (MBG´s) scaffolds with three-dimensional architecture have shown great potential for use as a bone substitutes. The osteostatin-enriched Sr-MBG used in this long bone defect in rabbit radius bone in vivo study showed an increase in bone formation close to autograft, which makes us think that it may be an option to consider as bone substitute.
在骨科领域,人们越来越需要开发用于治疗骨缺损的骨替代材料。生物材料工程的主要重点之一是先进的生物陶瓷,如中孔生物活性玻璃(MBG)。本研究比较了在成年新西兰兔桡骨长骨临界缺损中单独植入组成 82.5SiO-10CaO-5PO-x2.5SrO 的 MBG 支架(MBGA)、富含成骨蛋白的 MBG 支架(MBGO)或富含骨髓抽吸物的 MBG 支架(MBGB)12 周后的新骨形成。将 MBG 支架组的新骨形成与金标准的髂嵴自体移植物填充缺损和未填充缺损进行比较。在 2、6 和 12 周时进行放射学随访,并在 12 周时进行 microCT 和组织学检查。X 射线研究显示,自体移植物填充组的骨形成评分最高,其次是 MBGB 组,此外,microCT 研究显示,骨内缺损评分(BV/TV)在 MBGO 组较高。这种差异可以用富含成骨蛋白的 MBG 支架中新形成骨的密度较高来解释。因此,单独使用 MBG 支架以及富含成骨蛋白或骨髓抽吸物可增加骨形成,而富含成骨蛋白的支架效果更高。目前的结果表明,通过将 MBG 与成骨肽(如成骨蛋白)结合来治疗临界骨缺损具有潜力,并且很有希望转化为临床实践。
在骨科领域,由于美国每年约有 100,000 名患者受到影响,因此无法自行修复的骨缺损的治疗是一个全球性问题。在这些情况下的治疗金标准是自体移植物,但它的使用受到限制,无论是获得的移植物量还是供体部位产生的发病率。在材料工程领域,人们对开发等效的骨替代物越来越感兴趣。具有三维结构的中孔生物活性玻璃(MBG)支架具有很大的用作骨替代物的潜力。在这项体内研究中,在兔桡骨长骨缺陷中使用富含成骨蛋白的 Sr-MBG 可增加骨形成,接近自体移植物,这使我们认为它可能是一种可考虑的骨替代物。