Prefabrication of vascularized bioartificial bone grafts in vivo for segmental mandibular reconstruction: experimental pilot study in sheep and first clinical application
Prefabrication of vascularized bioartificial bone grafts in vivo for segmental mandibular reconstruction: experimental pilot study in sheep and first clinical application
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DOI：
10.1016/j.ijom.2010.01.010
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发表时间：
2010-04-01
影响因子：
2.4
通讯作者：
Gellrich, N. -C.
中科院分区：
文献类型：
--
作者：
Kokemueller, H.;Spalthoff, S.;Gellrich, N. -C.
在三维基质中形成生物人工骨的关键因素是大量的成骨细胞和氧气和营养的供应。随着颅颌面重建手术中所需的种植支架的尺寸和复杂性的增加，血管化变得更加重要。血管化生物人工骨移植物的体内预制备可能是体外组织工程技术的替代方法。两个圆柱形β-TCP支架（25 mm长）在术中填充自体骨髓从髂嵴细胞负载和植入背阔肌在12只绵羊。为了确定轴向灌注的效果，每只绵羊中的一个支架通过外科手术提供有中央血管束。手术后3个月处死绵羊。组织形态计量学分析显示，髂嵴自体骨髓是成骨细胞和生长因子的有效来源，在所有植入的支架中诱导相当多的异位骨生长。骨生长，陶瓷吸收和血管生成与轴向灌注显着增加。本研究结果为预制生物人工骨在下颌骨节段性重建中的应用提供了依据。在临床实践中，血管化生物人工骨移植物可以改变骨移植的原则，使供区并发症最小化，并且没有形状或体积的限制。
The key elements for bioartificial bone formation in 3D matrices are large numbers of osteogenic cells and supplies of oxygen and nutrition. Vascularization becomes more important with the increasing size and complexity of seeded scaffolds required for clinical application in reconstructive craniomaxillofacial surgery. Prefabrication of vascularized bioartificial bone grafts in vivo might be an alternative to in vitro tissue engineering techniques. Two cylindrical beta-TCP-scaffolds (25 mm long) were intraoperatively filled with autogenous bone marrow from the iliac crest for cell loading and implanted into the latissimus dorsi muscle in 12 sheep. To determine the effect of axial perfusion, one scaffold in each sheep was surgically supplied with a central vascular bundle. Sheep were killed 3 months after surgery. Histomorphometric analysis showed autogenous bone marrow from the iliac crest was an effective source of osteogenic cells and growth factors, inducing considerable ectopic bone growth in all implanted scaffolds. Bone growth, ceramic resorption and angiogenesis increased significantly with axial perfusion. The results encourage the application of prefabricated bioartificial bone for segmental mandibular reconstruction in man. In clinical practice, vascularized bioartificial bone grafts could change the principles of bone transplantation with minimal donor site morbidity and no shape or volume limitations.