Breitbart A S, Staffenberg D A, Thorne C H, Glat P M, Cunningham N S, Reddi A H, Ricci J, Steiner G
Institute of Reconstructive Plastic Surgery, New York University Medical Center, N.Y., USA.
Plast Reconstr Surg. 1995 Sep;96(3):699-708. doi: 10.1097/00006534-199509000-00024.
The disadvantages of autogenous bone grafts has prompted a search for a dependable onlay bone graft substitute. A combination of tricalcium phosphate, a resorbable ceramic, and osteogenin, an osteoinductive protein, was evaluated as an onlay bone graft substitute in a rabbit calvarial model. Twenty-eight tricalcium phosphate implants (15 mm diameter x 5 mm; pore size, 100-200 microns) were divided into experimental and control groups and placed on the frontal bone of 14 adult New Zealand White rabbits. In the experimental animals, 185 micrograms of osteogenin was added to each implant. In the control animals, the implants were placed untreated. Implants were harvested at intervals of 1, 3, and 6 months, and evaluated using hematoxylin and eosin histology, microradiography, and histomorphometric scanning electron microscope backscatter image analysis. At 1 month there was minimal bone ingrowth and little tricalcium phosphate resorption in both the osteogenin-treated and control implants. At 3 months, both the osteogenin-treated and control implants showed a modest increase in bone ingrowth (8.85 percent versus 5.87 percent) and decrease in tricalcium phosphate (32.86 percent versus 37.08 percent). At 6 months, however, the osteogenin-treated implants showed a statistically significant increase in bone ingrowth (22.33 percent versus 6.96 percent; p = 0.000) and decrease in tricalcium phosphate (27.25 percent versus 37.80 percent; p = 0.004) compared with the control implants. The bone within the control implants was mostly woven at 6 months, whereas the osteogenin-treated implants contained predominantly mature lamellar bone with well-differentiated marrow. All implants maintained their original volume at each time interval studied. The tricalcium phosphate/osteogenin composite, having the advantage of maintaining its volume and being replaced by new bone as the tricalcium phosphate resorbs, may be applicable clinically as an onlay bone graft substitute.
自体骨移植的缺点促使人们寻找一种可靠的贴敷式骨移植替代物。在兔颅骨模型中，对磷酸三钙（一种可吸收陶瓷）和骨生成素（一种骨诱导蛋白）的组合作为贴敷式骨移植替代物进行了评估。将28个磷酸三钙植入物（直径15毫米×5毫米；孔径100 - 200微米）分为实验组和对照组，并放置在14只成年新西兰白兔的额骨上。在实验组动物中，每个植入物添加185微克骨生成素。在对照组动物中，植入物未做处理直接放置。分别在1、3和6个月时取出植入物，使用苏木精和伊红组织学、微放射照相术以及组织形态计量学扫描电子显微镜背散射图像分析进行评估。1个月时，骨生成素处理组和对照组植入物的骨长入都极少，磷酸三钙吸收也很少。3个月时，骨生成素处理组和对照组植入物的骨长入均有适度增加（分别为8.85%和5.87%），磷酸三钙减少（分别为32.86%和37.08%）。然而，在6个月时，与对照组植入物相比，骨生成素处理组植入物的骨长入有统计学意义的显著增加（分别为22.33%和6.96%；p = 0.000），磷酸三钙减少（分别为27.25%和37.80%；p = 0.004）。对照组植入物内的骨在6个月时大多为编织骨，而骨生成素处理组植入物主要包含成熟的板层骨和分化良好的骨髓。在研究的每个时间间隔，所有植入物都保持其原始体积。磷酸三钙/骨生成素复合物具有保持其体积并随着磷酸三钙吸收而被新骨替代的优点，可能在临床上作为贴敷式骨移植替代物应用。
