Lam Kenrick, Bozynski Chantelle C, Cook Cristi R, Kuroki Keiichi, Bezold Will, Crist Brett D, Cook James L
Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.
Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, MO, USA; Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.
Injury. 2024 Jun;55(6):111590. doi: 10.1016/j.injury.2024.111590. Epub 2024 Apr 25.
To compare the bone healing effects of percutaneously delivered bone marrow aspirate concentrate (BMC) versus reamer irrigator aspirator (RIA) suspension in a validated preclinical canine ulnar nonunion model. We hypothesized that BMC would be superior to RIA in inducing bone formation across a nonunion site after percutaneous application. The null hypothesis was that BMC and RIA would be equivalent.
A bilateral ulnar nonunion model (n= 6; 3 matched pairs) was created. Eight weeks after segmental ulnar ostectomy, RIA from the ipsilateral femur and BMC from the proximal humerus were harvested and percutaneously administered into either the left or right ulnar defect. The same volume (3 ml) of RIA suspension and BMC were applied on each side. Eight weeks after treatment, the dogs were euthanized, and the nonunions were evaluated using radiographic, biomechanical, and histologic assessments.
All dogs survived for the intended study duration, formed radiographic nonunions 8 weeks after segmental ulnar ostectomy, and underwent the assigned percutaneous treatment. Radiographic and macroscopic assessments of bone healing at the defect sites revealed superior bridging-callous formation in BMC-treated nonunions. Histologic analyses revealed greater amount of bony bridging and callous formation in the BMC group. Biomechanical testing of the treated nonunions did not reveal any significant differences.
Bone marrow aspirate concentrate (BMC) had important advantages over Reamer Irrigator Aspirator (RIA) suspension for percutaneous augmentation of bone healing in a validated preclinical canine ulnar nonunion model based on clinically relevant radiographic and histologic measures of bone formation.
在经过验证的临床前犬尺骨骨不连模型中，比较经皮递送的骨髓抽吸浓缩物（BMC）与扩孔钻冲洗吸引器（RIA）悬浮液对骨愈合的影响。我们假设，经皮应用后，BMC在诱导骨不连部位形成骨方面优于RIA。无效假设是BMC和RIA等效。
建立双侧尺骨骨不连模型（n = 6；3对匹配组）。在尺骨节段性截骨术后8周，采集同侧股骨的RIA和肱骨近端的BMC，并经皮注入左侧或右侧尺骨缺损处。每侧应用相同体积（3 ml）的RIA悬浮液和BMC。治疗8周后，对犬实施安乐死，并通过影像学、生物力学和组织学评估对骨不连情况进行评价。
所有犬均存活至预定研究期限，在尺骨节段性截骨术后8周形成影像学骨不连，并接受了指定的经皮治疗。对缺损部位骨愈合的影像学和大体评估显示，BMC治疗的骨不连中骨痂桥接形成更优。组织学分析显示，BMC组的骨桥接和骨痂形成量更多。对治疗后的骨不连进行生物力学测试未发现任何显著差异。
在经过验证的临床前犬尺骨骨不连模型中，基于骨形成的临床相关影像学和组织学指标，骨髓抽吸浓缩物（BMC）在经皮促进骨愈合方面比扩孔钻冲洗吸引器（RIA）悬浮液具有重要优势。
