Angrisani Nina, von der Ahe Christin, Willumeit-Römer Regine, Windhagen Henning, Scheper Verena, Schwarze Michael, Wiese Björn, Helmholz Heike, Reifenrath Janin
Hannover Medical School, Clinic for Orthopaedic Surgery, Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Hannover, Lower Saxony, Germany.
Helmholtz-Zentrum Hereon, Institute of Metallic Biomaterials, Geesthacht, Germany.
Bioact Mater. 2024 Jun 18;40:366-377. doi: 10.1016/j.bioactmat.2024.06.003. eCollection 2024 Oct.
With its main features of cartilage degeneration, subchondral bone sclerosis and osteophyte formation, osteoarthritis represents a multifactorial disease with no effective treatment options. As biomechanical shift in the trabecular network may be a driver for further cartilage degeneration, bone enhancement could possibly delay OA progression. Magnesium is known to be osteoconductive and already showed positive effects in OA models. We aimed to use magnesium cylinders to enhance subchondral bone quality, condition of cartilage and pain sensation compared to sole drilling . After eight weeks of implantation in rabbits, significant increase in subchondral bone volume and trabecular thickness with constant bone mineral density was found indicating favored biomechanics. As representative for pain, a higher number of CD271+ vessels were present in control samples without magnesium. However, this result could not be confirmed by sensitive, objective lameness evaluation using a pressure sensing mat and no positive effect could be shown on either cartilage degeneration evaluated by OARSI score nor the presence of regenerative cells in CD271-stained samples. The presented results show a relevant impact of implanted magnesium on key structures in OA pain with missing clinical relevance regarding pain. Further studies with shifted focus should examine additional structures as joint capsule or osteophytes.
骨关节炎的主要特征为软骨退变、软骨下骨硬化和骨赘形成,是一种多因素疾病,目前尚无有效的治疗方法。由于小梁网络中的生物力学改变可能是导致软骨进一步退变的原因,增强骨骼可能会延缓骨关节炎的进展。镁具有骨传导性,并且已在骨关节炎模型中显示出积极效果。我们旨在使用镁圆柱体,与单纯钻孔相比,改善软骨下骨质量、软骨状况并减轻疼痛感。在兔子体内植入八周后,发现软骨下骨体积和小梁厚度显著增加,且骨矿物质密度保持不变,这表明生物力学得到改善。作为疼痛的指标,在未植入镁的对照样本中,CD271+血管数量更多。然而,使用压力传感垫进行的敏感、客观的跛行评估未能证实这一结果,而且无论是通过OARSI评分评估的软骨退变,还是CD271染色样本中再生细胞的存在,均未显示出积极效果。研究结果表明,植入的镁对骨关节炎疼痛的关键结构有显著影响,但在疼痛方面缺乏临床相关性。未来重点转移的进一步研究应检查其他结构,如关节囊或骨赘。