Department of Orthopedic Surgery, the First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang Province, China.
Department of Orthopedic Surgery, the Affiliated Hospital of Qinghai University, Xining, Qinghai, China.
BMC Musculoskelet Disord. 2024 Jun 8;25(1):455. doi: 10.1186/s12891-024-07567-y.
Masquelet membrane induction technology is one of the treatment strategies for large bone defect (LBD). However, the angiogenesis ability of induced membrane decreases with time and autologous bone grafting is associated with donor site morbidity. This study investigates if the PRP-FG-nHA/PA66 scaffold can be used as a spacer instead of PMMA to improve the angiogenesis ability of induced membrane and reduce the amount of autologous bone graft.
Platelet rich plasma (PRP) was prepared and PRP-FG-nHA/PA66 scaffold was synthesized and observed. The sustained release of VEGFA and porosity of the scaffold were analyzed. We established a femur LBD model in male SD rats. 55 rats were randomly divided into four groups depending on the spacer filled in the defect area. "Defect only" group (n = 10), "PMMA" group (n = 15), "PRP-nHA/PA66" group (n = 15) and "PRP-FG-nHA/PA66" group (n = 15 ). At 6 weeks, the spacers were removed and the defects were grafted. The induced membrane and bone were collected and stained. The bone formation was detected by micro-CT and the callus union was scored on a three point system.
The PRP-FG-nHA/PA66 scaffold was porosity and could maintain a high concentration of VEGFA after 30 days of preparation. The induced membrane in PRP-FG-nHA/PA66 group was thinner than PMMA, but the vessel density was higher.The weight of autogenous bone grafted in PRP-FG-nHA/PA66 group was significantly smaller than that of PMMA group. In PRP-FG-nHA/PA66 group, the bone defect was morphologically repaired.
The study showed that PRP-FG-nHA/PA66 scaffold can significantly reduce the amount of autologous bone graft, and can achieve similar bone defect repair effect as PMMA. Our findings provide some reference and theoretical support for the treatment of large segmental bone defects in humans.
Masquelet 诱导膜技术是治疗大骨缺损（LBD）的策略之一。然而，诱导膜的血管生成能力随时间而降低，且自体骨移植与供区发病率相关。本研究旨在探讨 PRP-FG-nHA/PA66 支架可否作为 PMMA 的替代品，以改善诱导膜的血管生成能力并减少自体骨移植量。
制备富血小板血浆（PRP），合成 PRP-FG-nHA/PA66 支架并观察其形态。分析支架中 VEGFA 的持续释放情况及支架的孔隙率。建立雄性 SD 大鼠股骨大骨缺损模型。将 55 只大鼠随机分为四组，根据缺损区填充的间隔物进行分组。“单纯缺损”组（n = 10）、“PMMA”组（n = 15）、“PRP-nHA/PA66”组（n = 15）和“PRP-FG-nHA/PA66”组（n = 15）。6 周时，取出间隔物并进行植骨。收集诱导膜和骨标本，行染色。通过 micro-CT 检测骨形成情况，并采用三点系统对骨痂愈合进行评分。
PRP-FG-nHA/PA66 支架具有一定的孔隙率，在制备 30 天后仍能保持较高浓度的 VEGFA。PRP-FG-nHA/PA66 组的诱导膜较 PMMA 组薄，但血管密度更高。PRP-FG-nHA/PA66 组自体骨移植量明显小于 PMMA 组。PRP-FG-nHA/PA66 组的骨缺损在形态上得到了修复。
本研究表明，PRP-FG-nHA/PA66 支架可显著减少自体骨移植量，且能达到与 PMMA 相似的骨缺损修复效果。本研究结果为人类大节段骨缺损的治疗提供了一定的参考和理论依据。
