Preclinical models of orthopaedic trauma: Orthopaedic Research Society (ORS) and Orthopaedic Trauma Association (OTA) symposium 2022.
Preclinical models of orthopaedic trauma: Orthopaedic Research Society (ORS) and Orthopaedic Trauma Association (OTA) symposium 2022.
复制标题
骨科创伤的临床前模型：2022 年骨科研究协会 (ORS) 和骨科创伤协会 (OTA) 研讨会。
DOI：
10.1097/oi9.0000000000000303
复制
发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Bahney,ChelseaS
中科院分区：
文献类型：
--
作者：
Wise,PatrickM;Saiz,AugustineM;Haller,Justin;Wenke,JosephC;Schaer,Thomas;Schneider,Prism;Morshed,Saam;Bahney,ChelseaS
骨科创伤仍然是导致患者发病率、死亡率和全球卫生保健负担的主要原因。尽管在这些损伤的诊断、治疗和康复方面取得了重大进展，但仍会出现畸形愈合、骨不连、感染、废用性肌肉萎缩和骨量减少以及未完全恢复到基线功能等并发症。骨折治疗中固有的显著临床变异性，如不同的患者人口统计、损伤模式和治疗方案，使得标准化和可复制的研究，特别是基于细胞和分子的机制的研究几乎是不可能的。因此，致力于改善骨科创伤患者的治疗和治疗的科学家依赖于临床前模型。临床前模型已被证明在了解植入物插入和细菌接种之间的时间间隔方面具有非常宝贵的价值。创伤后关节炎(PTOA)临床上可能需要数年时间才能形成，但使用猪Pilon骨折模型，可以可靠地诱导创伤后关节炎，因此可以测试不同的手术和治疗策略来预防。相反，赛马呈现了自然发生的PTOA的一个被广泛接受的模型。临床前多发伤模型主要集中在胸部损伤、腹部损伤、多发骨折和/或头部损伤，可以系统地研究各种损伤模式对骨折愈合的影响。最后，这些临床前模型充当了临床应用于人类患者的翻译桥梁。通过选择正确的临床前模型，研究可以建立一个平台，以降低新兴技术的风险，并为治疗性临床试验提供基础支持。总而言之，骨科创伤临床前模型使科学家能够简化复杂的临床挑战，了解从低级脊椎动物模型开始的基本途径。然后，研发工作进展到更高的脊椎动物模型，以建立更复杂的将发现转化为临床实践。
Orthopaedic trauma remains a leading cause of patient morbidity, mortality, and global health care burden. Although significant advances have been made in the diagnosis, treatment, and rehabilitation of these injuries, complications such as malunion, nonunion, infection, disuse muscle atrophy and osteopenia, and incomplete return to baseline function still occur. The significant inherent clinical variability in fracture care such as differing patient demographics, injury patterns, and treatment protocols make standardized and replicable study, especially of cellular and molecular based mechanisms, nearly impossible. Hence, the scientists dedicated to improving therapy and treatments for patients with orthopaedic trauma rely on preclinical models. Preclinical models have proven to be invaluable in understanding the timing between implant insertion and bacterial inoculation on the bioburden of infection. Posttraumatic arthritis (PTOA) can take years to develop clinically, but with a porcine pilon fracture model, posttraumatic arthritis can be reliably induced, so different surgical and therapeutic strategies can be tested in prevention. Conversely, the racehorse presents a well-accepted model of naturally occurring PTOA. With preclinical polytrauma models focusing on chest injury, abdominal injury, multiple fractures, and/or head injury, one can study how various injury patterns affect fracture healing can be systemically studied. Finally, these preclinical models serve as a translational bridge to for clinical application in human patients. With selection of the right preclinical model, studies can build a platform to decrease the risk of emerging technologies and provide foundational support for therapeutic clinical trials. In summary, orthopaedic trauma preclinical models allow scientists to simplify a complex clinical challenge, to understand the basic pathways starting with lower vertebrate models. Then, R&D efforts progress to higher vertebrate models to build in more complexity for translation of findings to the clinical practice.