Low-magnitude high-frequency mechanical signals accelerate and augment endochondral bone repair: preliminary evidence of efficacy.
Low-magnitude high-frequency mechanical signals accelerate and augment endochondral bone repair: preliminary evidence of efficacy.
复制标题
DOI：
10.1002/jor.20824
复制
发表时间：
2009-07
影响因子：
2.8
通讯作者：
Rubin, Clinton T.
中科院分区：
文献类型：
--
作者：
Goodship, Allen E.;Lawes, Timothy J.;Rubin, Clinton T.
骨折愈合可以通过承重来增强，但是可以增强或加速该过程的机械环境的特定成分仍然未知。低幅值，高频机械信号的能力，骨组织中的合成代谢，在这里评估其影响骨折愈合的能力。在羊胫骨中段3 mm截骨术中，评价了短时间（17 min）、极低幅度（25 μm）、高频（30 Hz）骨折块间移位促进骨折愈合的潜力。在一项概念验证和临床相关性的初步研究中，将采用刚性外固定器（对照组：n = 4）稳定的截骨术的愈合情况与采用相同固定刚度但补充每日机械负荷的截骨术（实验组：n = 4）的愈合情况进行了比较。这些25 μm的位移是由外固定器主体中的铁活性形状记忆合金（“智能”材料）引起的，小于3 mm骨折间隙的1%，小于在Amphetry期间在该部位测量的0.45 mm位移的6%（p <0.001）。术后10周，实验组的骨痂比对照组硬3.6倍（p <0.03）、强2.5倍（p =0.05）、大29%（p <0.01）。实验组的骨矿物质含量增加了52%（p <0.02），骨膜区域的骨矿物质含量（BMC）增加了2.6倍（p <0.001）。这些数据强化了机械因素在增强骨折愈合中的关键作用，并强调信号不需要很大才能对功能恢复产生影响和潜在的临床优势。
Fracture healing can be enhanced by load bearing, but the specific components of the mechanical environment which can augment or accelerate the process remain unknown. The ability of low-magnitude, high-frequency mechanical signals, anabolic in bone tissue, are evaluated here for their ability to influence fracture healing. The potential for short duration (17 min), extremely low-magnitude (25 μm), high-frequency (30 Hz) interfragmentary displacements to enhance fracture healing was evaluated in a mid-diaphyseal, 3-mm osteotomy of the sheep tibia. In a pilot study of proof of concept and clinical relevance, healing in osteotomies stabilized with rigid external fixation (Control: n = 4), were compared to the healing status of osteotomies with the same stiffness of fixation, but supplemented with daily mechanical loading (Experimental: n = 4). These 25-μm displacements, induced by a ferroactive shape-memory alloy (“smart” material) incorporated into the body of the external fixator, were less than 1% of the 3-mm fracture gap, and less than 6% of the 0.45-mm displacement measured at the site during ambulation (p <0.001). At 10-weeks post-op, the callus in the Experimental group was 3.6-fold stiffer (p <0.03), 2.5-fold stronger (p =0.05), and 29% larger (p <0.01) than Controls. Bone mineral content was 52% greater in the Experimental group (p <0.02), with a 2.6-fold increase in bone mineral content (BMC) in the region of the periosteum (p <0.001). These data reinforce the critical role of mechanical factors in the enhancement of fracture healing, and emphasize that the signals need not be large to be influential and potentially clinically advantageous to the restoration of function.
登录
查看更多内容
影响因子：
2.3
作者：
Claes, L;Eckert-Hübner, K;Augat, P
通讯作者：
Augat, P
影响因子：
2.8
作者：
Augat, P;Margevicius, K;Claes, L
通讯作者：
Claes, L
DOI：
10.2106/00004623-197961040-00008
发表时间：
1979-01-01
影响因子：
5.3
作者：
GOODSHIP, AE;LANYON, LE;MCFIE, H
通讯作者：
MCFIE, H
影响因子：
2.8
作者：
CARTER, DR;BLENMAN, PR;BEAUPRE, GS
通讯作者：
BEAUPRE, GS
影响因子：
2.4
作者：
Fritton, SP;McLeod, KJ;Rubin, CT
通讯作者：
Rubin, CT