Interaction between living bone particles and rhBMP-2 in large segmental defect healing in the rat femur.
Interaction between living bone particles and rhBMP-2 in large segmental defect healing in the rat femur.
复制标题
DOI：
10.1002/jor.23255
复制
发表时间：
2016-12
期刊：
影响因子：
--
通讯作者：
Ferreira E
中科院分区：
文献类型：
--
作者：
Liu F;Wells JW;Porter RM;Glatt V;Shen Z;Schinhan M;Ivkovic A;Vrahas MS;Evans CH;Ferreira E
骨科医生在处理有问题的骨折时，有时会将联合收割机重组人BMP-2与自体骨结合。虽然一些病例报告表明这种标签外策略取得了成功，但还没有随机对照试验。此外，文献检索仅显示了一项临床前研究，该研究是在颅骨缺损模型中进行的。因此，本项目研究了在大鼠股骨缺损模型中将不同剂量的BMP-2与活骨颗粒相结合的后果。使用扩髓器-冲洗器-抽吸器回收人骨颗粒。为了允许接受异种移植物作为替代自体移植物，向大鼠施用不干扰骨愈合的免疫抑制鸡尾酒。植入200 μg活骨颗粒产生少量新骨，缺损未愈合。将单独引起不愈合（1.1 μg）、边界愈合（5.5 μg）或完全愈合（11 μg）的分级量的BMP-2加入到该量的人骨颗粒中。添加BMP-2（1.1 μg）可增加骨生成，并在7个缺损中的2个中产生桥接。BMP-2（5.5 μg）和骨颗粒的定量作用充其量是相加的，但使愈合更可靠并促进再生物的成熟。BMP-2（11 μg）和骨颗粒的成骨作用小于添加剂，主要作用是促进新形成骨的成熟。数据表明，自体移植物和BMP-2的组合在存在愈合反应但不理想的情况下在临床上是有帮助的。
Orthopaedic surgeons sometimes combine recombinant, human BMP -2 with autograft bone when dealing with problematic osseous fractures. Although some case reports indicate success with this off-label strategy, there have been no randomized controlled trials. Moreover, a literature search revealed only one pre-clinical study and this was in a cranial defect model. The present project thus examined the consequences of combining different doses of BMP-2 with particles of living bone in a rat femoral defect model. Human bone particles were recovered with a reamer-irrigator-aspirator. To allow acceptance of the xenograft as surrogate autograft, rats were administered an immunosuppressive cocktail that does not interfere with bone healing. Implantation of 200 μg living bone particles generated a small amount of new bone and defects did not heal. Graded amounts of BMP-2 that alone provoked no healing (1.1 μg), borderline healing (5.5 μg) or full healing (11 μg) were added to this amount of human bone particles. Addition of BMP-2 (1.1 μg) increased osteogenesis, and produced bridging in 2 of 7 defects. The quantitative effects of BMP-2 (5.5 μg) and bone particles were additive at best, but made healing more reliable and advanced the maturation of the regenerate. Bone formation with BMP-2 (11 μg) and bone particles was less than additive, and the major effect was to improve the maturation of the newly formed bone. The data suggest that the combination of autograft and BMP-2 can be helpful clinically under conditions where a healing response is present, but suboptimal.