Osteogenic potential of reamer irrigator aspirator (RIA) aspirate collected from patients undergoing hip arthroplasty.
Osteogenic potential of reamer irrigator aspirator (RIA) aspirate collected from patients undergoing hip arthroplasty.
复制标题
从接受髋关节置换术的患者身上收集的扩孔器冲洗吸引器 (RIA) 抽吸物的成骨潜力。
DOI：
10.1002/jor.20715
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Evans,ChristopherH
中科院分区：
文献类型：
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作者：
Porter,RyanM;Liu,Fangjun;Pilapil,Carmencita;Betz,OliverB;Vrahas,MarkS;Harris,MitchelB;Evans,ChristopherH
髓内钉内固定加髓腔扩髓是目前需要稳定的长骨骨折的标准治疗方法。然而，传统的扩髓方法会升高髓内温度和压力，可能导致骨坏死、全身栓塞和肺部并发症。为了解决这一问题，开发了一种扩髓钻冲洗吸引器（RIA），将冲洗和吸引结合起来，用于减压扩髓和温度调节。通过RIA抽吸的骨颗粒可以通过过滤回收，用作自体移植物，但通常丢弃流过物。本研究的目的是评估该丢弃的滤液是否具有可用于增强抽吸物的总修复潜力的成骨特性。RIA抽吸物收集自5名接受半髋关节置换术的患者（年龄71-78岁）。使用开孔过滤器去除骨颗粒，并通过Ficoll梯度离心处理所得滤液（230 ± 200 mL），以分离单核细胞（6.2 ± 5.2 × 106个细胞/mL）。水性上清液含有FGF-2、IGF-1和潜伏性TGF-β1，但BMP-2低于检测限。细胞部分包括培养塑料粘附的成纤维细胞，其显示出指示间充质干细胞的表面标志物特征，并且可以在体外沿着成骨、成脂和成软骨谱系诱导。与骨颗粒培养的生长细胞相比，滤液细胞在成骨培养过程中对接种密度更敏感，但具有相似的软骨形成能力。这些结果表明，使用RIA抽吸物可以开发出改进的、临床上快速的、具有成本效益的技术，用于加速骨和其他肌肉骨骼组织的愈合。© 2008骨科研究学会。由威利期刊公司出版J Orthop Res 27：42-49，2009
Intramedullary nailing preceded by canal reaming is the current standard of treatment for long‐bone fractures requiring stabilization. However, conventional reaming methods can elevate intramedullary temperature and pressure, potentially resulting in necrotic bone, systemic embolism, and pulmonary complications. To address this problem, a reamer irrigator aspirator (RIA) has been developed that combines irrigation and suction for reduced‐pressure reaming with temperature modulation. Osseous particles aspirated by the RIA can be recovered by filtration for use as an autograft, but the flow‐through is typically discarded. The purpose of this study was to assess whether this discarded filtrate has osteogenic properties that could be used to enhance the total repair potential of aspirate. RIA aspirate was collected from five patients (ages 71–78) undergoing hip hemiarthroplasty. Osseous particles were removed using an open‐pore filter, and the resulting filtrate (230 ± 200 mL) was processed by Ficoll‐gradient centrifugation to isolate mononuclear cells (6.2 ± 5.2 × 106cells/mL). The aqueous supernatant contained FGF‐2, IGF‐I, and latent TGF‐β1, but BMP‐2 was below the limit of detection. The cell fraction included culture plastic‐adherent, fibroblastic cells that displayed a surface marker profile indicative of mesenchymal stem cells and that could be induced along the osteogenic, adipogenic, and chondrogenic lineages in vitro. When compared to outgrowth cells from the culture of osseous particles, filtrate cells were more sensitive to seeding density during osteogenic culture but had similar capacity for chondrogenesis. These results suggest using RIA aspirate to develop improved, clinically expeditious, cost‐effective technologies for accelerating the healing of bone and other musculoskeletal tissues. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:42–49, 2009