Testing the critical size in calvarial bone defects: revisiting the concept of a critical-size defect.
Testing the critical size in calvarial bone defects: revisiting the concept of a critical-size defect.
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DOI：
10.1097/prs.0b013e3181cb63a3
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发表时间：
2010-06
影响因子：
3.6
通讯作者：
Huard J
中科院分区：
文献类型：
--
作者：
Cooper GM;Mooney MP;Gosain AK;Campbell PG;Losee JE;Huard J
由于自体骨移植的不足，特别是在儿科患者人群中，临床上需要骨置换策略。在过去的25年中，用于测试骨置换策略的动物模型一直是基于骨缺损的初始尺寸的颅骨临界尺寸缺损（CSD）。本研究是在几个不同的模型中进行测试的临界尺寸的概念。还审查了可持续发展委员会的理论和科学基础。使用两种不同的啮齿动物物种（包括28只成年小鼠和6只成年大鼠），在使用不同的手术技术创建小骨缺损后，通过2D放射学分析评估骨愈合。小鼠体内小于临界尺寸（1.8毫米直径）的缺陷在术后一年最多可愈合50%。大鼠颅骨中的小（2.3mm直径）缺损在6周后显示出约35%的愈合。啮齿动物种类的选择和硬脑膜的维护都不会显著影响颅骨愈合。这些结果表明，颅骨愈合没有得到很好的描述，需要收集更多的数据。此外，在对现有文献进行回顾并对模型的临床适用性进行批判后，建议停止使用术语“临界尺寸缺损”。
There is a clinical need for bone replacement strategies because of the shortfalls endemic to autologous bone grafting, especially in the pediatric patient population. For the past 25 years, the animal model that has been used to test bone replacement strategies has been the calvarial critical-sized defect (CSD), based on the initial size of the bone defect. This study was undertaken to test the concept of the critical-size in several different models. A review of the theoretical and scientific bases for the CSD was also undertaken. Two different rodent species (including 28 adult mice and 6 adult rats) were used to assess bone healing via 2D radiographic analysis after creating small bone defects using different surgical techniques. Defects in mice that were smaller than critical-sized (1.8mm diameter) were shown to heal a maximum of 50% one year postoperatively. Small (2.3mm diameter) defects in the rat skull showed approximately 35% healing after 6 weeks. Neither the choice of rodent species nor the maintenance of the dura mater significantly affected calvarial bone healing. These results suggest that calvarial bone healing is not well described and much more data needs to be collected. Also, after a review of the existing literature and a critique of the clinical applicability of the model, it is suggested that the use of the term “critical-sized defect” be discontinued.