Treating Proximal Tibial Growth Plate Injuries Using Poly(Lactic-co-Glycolic Acid) Scaffolds
Treating Proximal Tibial Growth Plate Injuries Using Poly(Lactic-co-Glycolic Acid) Scaffolds
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DOI：
10.1089/biores.2014.0034
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发表时间：
2015-07-01
影响因子：
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通讯作者：
Puleo, David A.
中科院分区：
文献类型：
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作者：
Clark, Amanda;Hilt, J. Zach;Puleo, David A.
生长板骨折占儿童骨折的近18.5%。根据损伤的类型和严重程度，可能发生骨生长抑制或骨形成代替生长板引起的成角畸形。目前的治疗方法包括切除骨棒，并用填充物（如游离脂肪移植物）代替。不幸的是，骨杆的重建经常发生，阻止天然生长板再生。这项初步研究的目的是确定可生物降解支架是否可以增强新西兰白色兔胫骨近端生长板模拟损伤后的天然生长板再生，导致骨棒形成。移除骨棒后，动物接受以下处理之一：多孔聚（乳酸-共-乙醇酸）（PLGA）支架;负载胰岛素样生长因子I（IGF-I）的PLGA支架;负载IGF-I并接种植入时收获的自体骨髓细胞（BMC）的PLGA支架;或脂肪移植物（临床使用）。与脂肪移植组（对照组）相比，PLGA支架组显示软骨细胞群增加，剩余的天然生长板损失减少。在加载有IGF-I的支架中观察到软骨细胞密度的额外增加，并且当将BMC接种在支架上时更是如此。虽然肢体的角变形没有显著减少，但PLGA支架增加了软骨的量并减少了骨杆重建的量。
Growth plate fractures account for nearly 18.5% of fractures in children. Depending on the type and severity of the injury, inhibited bone growth or angular deformity caused by bone forming in place of the growth plate can occur. The current treatment involves removal of the bony bar and replacing it with a filler substance, such as a free fat graft. Unfortunately, reformation of the bony bar frequently occurs, preventing the native growth plate from regenerating. The goal of this pilot study was to determine whether biodegradable scaffolds can enhance native growth plate regeneration following a simulated injury that resulted in bony bar formation in the proximal tibial growth plate of New Zealand white rabbits. After removing the bony bar, animals received one of the following treatments: porous poly(lactic-co-glycolic acid) (PLGA) scaffold; PLGA scaffold loaded with insulin-like growth factor I (IGF-I); PLGA scaffold loaded with IGF-I and seeded with autogenous bone marrow cells (BMCs) harvested at the time of implantation; or fat graft (as used clinically). The PLGA scaffold group showed an increased chondrocyte population and a reduced loss of the remaining native growth plate compared to the fat graft group (the control group). An additional increase in chondrocyte density was seen in scaffolds loaded with IGF-I, and even more so when BMCs were seeded on the scaffold. While there was no significant reduction in the angular deformation of the limbs, the PLGA scaffolds increased the amount of cartilage and reduced the amount of bony bar reformation.