Differential effects of culture-expanded bone marrow cells on the regeneration of bone between the femoral and the tibial lengthenings.
Differential effects of culture-expanded bone marrow cells on the regeneration of bone between the femoral and the tibial lengthenings.
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DOI：
10.1097/bpo.0b013e3181b2afb2
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发表时间：
2009-09-01
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影响因子：
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通讯作者：
Ishiguro, Naoki
中科院分区：
文献类型：
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作者：
Kitoh, Hiroshi;Kawasumi, Motoaki;Ishiguro, Naoki
背景技术背景：在肢体延长过程中移植培养扩增的骨髓细胞（BMC）和富血小板血浆（PRP）通过加速骨痂形成缩短了治疗时间，但BMC和PRP对骨再生的直接影响尚未确定。28例患者（男17例，女11例）51块骨（股骨23块，胫骨28块），平均年龄15.0 ± 3.21岁。比较了51例接受BMC和PRP治疗的骨骼和60例未接受细胞治疗的骨骼的临床结果。比较股骨和胫骨用BMC和PRP处理的参数，包括手术年龄、长度增加、愈合指数（HI）、BMC数量、BMC的骨特异性碱性磷酸酶（BAP）活性和PRP浓度。结果：BMC组和PRP组的HI均显著低于对照组，且各组间无显著性差异。平均HI、延长量、BMC数量、BAP活性和PRP浓度分别为30.0+/-6.72天/cm、8.10+/-2.90 cm、1.35+/-0.56 x 10（7）、9.02+/-3.98 U/L和2.4+/-0.7 x 10（6）/UL。股骨和胫骨的长度增长、BMC数量和BAP活性以及PRP浓度无显著差异。股骨延长术的愈合速度明显快于胫骨延长术，尽管股骨延长术的手术年龄明显更大。在胫骨中观察到HI和长度增加之间的负相关性。在股骨，有一个负的线性关系之间的HI和BMC的数量和BAP活性，而没有显着的相关性被检测到在tibias.CONCLUSIONS：在股骨延长，减少HI是显着的BMC和PRP移植，并有一个渐进的增加，骨愈合的数量和移植BMC的成骨细胞分化的增加。我们的研究结果表明，区域不同的细胞移植骨形成过程可能与局部血液供应和软组织covering. Level证据：治疗回顾性研究，III级。
BACKGROUND: Transplantation of culture-expanded bone marrow cells (BMC) and platelet-rich plasma (PRP) during limb lengthening shorten the treatment period by accelerating callus formation, but the direct effects of BMC and PRP on the regeneration of the bone have not been determined.METHODS: Fifty-one bones (23 femora, 28 tibiae) in 28 patients (17 males, 11 females), with an average age of 15.0+/-3.21 years, were lengthened by treatment with BMC and PRP. Clinical outcome was compared between the 51 bones with BMC and PRP treatment and the 60 bones without cell therapy. The parameters including age at surgery, length gained, healing index (HI), number of BMC, bone-specific alkaline phosphatase (BAP) activity of BMC, and PRP concentration, were compared between the femur and the tibia treated with BMC and PRP. Linear regression analysis was then performed to correlate the HI and other variables.RESULTS: The HI of the BMC and PRP groups was significantly lower than that of the control group. Average HI, amount of lengthening, number of BMC, BAP activity, and PRP concentration were 30.0+/-6.72 days/cm, 8.10+/-2.90 cm, 1.35+/-0.56 x 10(7), 9.02+/-3.98 U/L, and 2.4+/-0.7 x 10(6)/UL, respectively. There were no significant differences in the length gained, the number and BAP activity of BMC, and the PRP concentration between the femur and the tibia. Femoral lengthening showed significantly faster healing than tibial lengthening, although the age at surgery was significantly older in femoral lengthening. A negative relationship between the HI and the length gained was observed in the tibia. In the femur, there was a negative linear relationship between the HI and the number and BAP activity of BMC, whereas no significant correlations were detected in the tibia.CONCLUSIONS: In femoral lengthening, decrease in the HI was remarkable by BMC and PRP transplantation, and there was a progressive increase in bone healing as the number and the osteoblastic differentiation of transplanted BMC increased. Our results suggested that regionally varying bone-forming processes by cell transplantation might be related to local blood supply and soft tissue covering.LEVEL OF EVIDENCE: Therapeutic retrospective study, level III.