Progress in biological reconstruction and enhanced bone revitalization for bone defects
Progress in biological reconstruction and enhanced bone revitalization for bone defects
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DOI：
10.1016/j.jos.2019.01.015
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发表时间：
2019-05-01
影响因子：
1.7
通讯作者：
Tsuchiya, Hiroyuki
中科院分区：
文献类型：
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作者：
Yamamoto, Norio;Hayashi, Katsuhiro;Tsuchiya, Hiroyuki
使用人工材料重建骨缺损可能会在短期内产生良好的功能恢复。随着时间的推移，人造材料的耐久性成为一个问题，因此，人造材料不能被认为是重建的永久解决方案。对于长期的结果，目标是恢复功能，永久性，以及尽可能接近正常的形式。因此，生理材料是理想的用于重建。生物重建包括使用在骨缺损重建后在体内改性的材料。其目标是实现骨愈合、骨再生和骨重建，同时实现软组织和骨的生物整合。在世界上大多数地区，同种异体骨的使用一直是骨缺损重建的支柱，尽管在日本等一些国家，由于社会宗教问题，同种异体骨很难获得。因此，我们开发了新的生物重建技术来克服这一问题，牵张成骨所获得的骨是自体骨，它具有生物亲和性、强度、弹性和抗感染性，是一种理想的重建材料。然而，当将这种方法应用于恶性疾病患者时，重要的是尽可能多地保留局部软组织，并且临床医生必须特别小心感染和骨痂形成。与迄今为止的其他形式的治疗相比，液氮治疗荷瘤骨产生相等的（如果不是更好的话）骨再生。用液氮处理的骨重建包括切除病变骨并在液氮处理后将其返回体内（自由冷冻法）。另一种方法涉及使肿瘤近端的关节脱位，或在远端侧保持与身体连接的同时切割骨，并将肢体倒置并用液氮治疗（蒂冷冻法）。当这两种方法都可行时，椎弓根冷冻法是优选的，因为它是以最小的截骨术进行的。我们最近的研究已经探讨了脂肪来源的干细胞在促进骨融合和再生中的可能作用。这种方法为未来的生物重建产生了有希望的结果。(c)2019年日本骨科协会。由爱思唯尔公司出版。这是一篇开放获取的文章，获得了CC BY-NC-ND许可证（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
Bone defect reconstruction with artificial materials may produce good functional recovery in the short term. Over time, the durability of artificial materials becomes an issue, and therefore, artificial materials cannot be considered a permanent solution to reconstruction. For long-term outcomes, the goal is to regain function, permanence, and form that are as close to normal as possible. Thus, physiological materials are desirable for use in reconstruction.Biological reconstruction involves the use of materials that are modified in vivo following reconstruction of bone defects. The goal is to achieve bone union, bone revival and remodeling, with biointegration of soft tissue and bone. Allograft use has been the mainstay of bone defect reconstruction in most parts of the world, although in some countries like Japan, allogeneic bone is difficult to obtain due to socio-religious concerns. Therefore, we developed new biological reconstruction techniques to overcome this problem.Bone derived from distraction osteogenesis is autologous bone, which must be an ideal reconstruction material for its biological affinity, strength, resilience, and immunity to infection. When applying this method to patients with malignant disease however, it is important to preserve as much of the local soft tissue as possible, and the clinician must be especially careful of infection and callus formation. Liquid nitrogen treatment of tumor-bearing bone produces equal, if not better, bone revitalization compared to other forms of treatment to date. Reconstruction with liquid nitrogen-treated bone involves resecting the diseased bone and returning it to the body following liquid nitrogen treatment (free-freezing method). Another method involves dislocating the joint proximal to the tumor, or cutting the bone while the distal side remains attached to the body and the limb inverted and treated with liquid nitrogen (pedicle freezing method). When both methods are possible, the pedicle freezing method is preferable since it is performed with minimal osteotomy.Our recent research has looked into the possible role of adipose-derived stem cells in promoting bone fusion and revitalization. This method has produced promising results for the future of biological reconstruction. (c) 2019 The Japanese Orthopaedic Association. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).