Altering spacer material affects bone regeneration in the Masquelet technique in a rat femoral defect
Altering spacer material affects bone regeneration in the Masquelet technique in a rat femoral defect
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DOI：
10.1002/jor.23866
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发表时间：
2018-08-01
影响因子：
2.8
通讯作者：
Nicolaou, Daemeon
中科院分区：
文献类型：
--
作者：
McBride-Gagyi, Sarah;Toth, Zacharie;Nicolaou, Daemeon
Masquelet技术依赖于预先开发的异物膜，以支持骨再生，移植物比传统的最大值大三倍。迄今为止，该手术一直使用由骨水泥制成的垫片，骨水泥是聚合物聚甲基丙烯酸甲酯（PMMA），以诱导异物膜。本研究旨在比较（i）Masquelet环境中PMMA、钛和聚乙烯醇海绵（PVA）垫片形成的膜的形态、因子表达和细胞构成，以及（ii）相同组中的后续骨再生。对10周龄雄性Sprague-Dawley大鼠给予外部稳定的6 mm股骨缺损，并植入PMMA、钛或PVA预制垫片。所有动物均在4周内形成膜，接受同种移植物的动物在植入后10周愈合。所有样本均用microCT扫描，以测量1期和2期骨形成。处理膜样品用于组织学以测量膜形态、细胞构成和因子BMP 2、TGF、VEGF和IL 6的表达。PMMA和钛间隔器产生了几乎相同的膜和1期骨。PVA间隔物均匀地被组织和细胞浸润，并且没有形成明显的膜。2期骨形成无定量差异。然而，PMMA诱导膜支持7个样品中的6个的功能性结合，而大多数钛和PVA组未能实现相同的功能性结合。间隔物材料可以改变膜，足以破坏第2阶段骨形成。膜在骨再生中的作用可能不仅仅是物理屏障。(c)2018骨科研究学会。由威利期刊公司出版J Orthop Res 36：2228-2238，2018。
The Masquelet technique depends on pre-development of a foreign-body membrane to support bone regeneration with grafts over three times larger than the traditional maximum. To date, the procedure has always used spacers made of bone cement, which is the polymer polymethyl methacrylate (PMMA), to induce the foreign-body membrane. This study sought to compare (i) morphology, factor expression, and cellularity in membranes formed by PMMA, titanium, and polyvinyl alcohol sponge (PVA) spacers in the Masquelet milieu and (ii) subsequent bone regeneration in the same groups. Ten-week-old, male Sprague-Dawley rats were given an externally stabilized, 6mm femur defect, and a pre-made spacer of PMMA, titanium, or PVA was implanted. All animals were given 4 weeks to form a membrane, and those receiving an isograft were given 10 weeks post-implantation to union. All samples were scanned with microCT to measure phase 1 and phase 2 bone formation. Membrane samples were processed for histology to measure membrane morphology, cellularity, and expression of the factors BMP2, TGF, VEGF, and IL6. PMMA and titanium spacers created almost identical membranes and phase 1 bone. PVA spacers were uniformly infiltrated with tissue and cells and did not form a distinct membrane. There were no quantitative differences in phase 2 bone formation. However, PMMA induced membranes supported functional union in 6 of 7 samples while a majority of titanium and PVA groups failed to achieve the same. Spacer material can alter the membrane enough to disrupt phase 2 bone formation. The membrane's role in bone regeneration is likely more than just as a physical barrier. (c) 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2228-2238, 2018.