Successful human long-term application of in situ bone tissue engineering.
Successful human long-term application of in situ bone tissue engineering.
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DOI：
10.1111/jcmm.12296
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发表时间：
2014-07
影响因子：
5.3
通讯作者：
Arkudas A
中科院分区：
文献类型：
--
作者：
Horch RE;Beier JP;Kneser U;Arkudas A
组织工程（TE）和再生医学（RM）因其治疗组织和器官缺陷患者的巨大前景而广受欢迎。为了克服标准自体骨移植物供体部位发病率的常见问题，我们首次成功地将组织工程技术与动静脉环模型相结合，生成带血管的大骨移植物。我们介绍了两例骨髓炎清创后出现大骨缺损的病例。其中一种缺陷位于桡骨，另一种位于胫骨。对于骨重建，创建动静脉环作为血管轴，将其放置在骨缺损处。在病例 1 中，使用来自髂嵴的松质骨和纤维蛋白胶实现骨生成，在病例 2 中，使用临床批准的 β-磷酸三钙/羟基磷灰石 (HA)、纤维蛋白胶和直接从髂嵴抽取的自体移植骨髓来实现骨生成。接下来的术后过程很顺利。最终检查在初次手术后 36 个月和 72 个月后进行。计算机断层扫描 (CT)、膜磁共振成像 (MRI) 和多普勒超声显示骨移植物中存在开放的动静脉 (AV) 环以及完全愈合的骨缺损。患者无疼痛，活动范围正常。这是第一项研究，证明在临床场景中使用动静脉环模型成功地在大骨缺损中进行轴向血管化原位组织工程骨生成，而不会在人类患者中使用 TE 和 RM 技术产生显着的供体部位缺损，且具有长期稳定性。
Tissue Engineering (TE) and Regenerative Medicine (RM) have gained much popularity because of the tremendous prospects for the care of patients with tissue and organ defects. To overcome the common problem of donor-site morbidity of standard autologous bone grafts, we successfully combined tissue engineering techniques for the first time with the arteriovenous loop model to generate vascularized large bone grafts. We present two cases of large bone defects after debridement of an osteomyelitis. One of the defects was localized in the radius and one in the tibia. For osseus reconstruction, arteriovenous loops were created as vascular axis, which were placed in the bony defects. In case 1, the bone generation was achieved using cancellous bone from the iliac crest and fibrin glue and in case 2 using a clinically approved β-tricalciumphosphate/hydroxyapatite (HA), fibrin glue and directly auto-transplanted bone marrow aspirate from the iliac crest. The following post-operative courses were uneventful. The final examinations took place after 36 and 72 months after the initial operations. Computer tomogrphy (CT), membrane resonance imaging (MRI) and doppler ultrasound revealed patent arterio-venous (AV) loops in the bone grafts as well as completely healed bone defects. The patients were pain-free with normal ranges of motion. This is the first study demonstrating successfully axially vascularized in situ tissue engineered bone generation in large bone defects in a clinical scenario using the arteriovenous loop model without creation of a significant donor-site defect utilizing TE and RM techniques in human patients with long-term stability.
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影响因子：
5.3
作者：
Boos AM;Loew JS;Deschler G;Arkudas A;Bleiziffer O;Gulle H;Dragu A;Kneser U;Horch RE;Beier JP
通讯作者：
Beier JP
影响因子：
5.3
作者：
Horch RE;Boos AM;Quan Y;Bleiziffer O;Detsch R;Boccaccini AR;Alexiou C;Sun J;Beier JP;Arkudas A
通讯作者：
Arkudas A
影响因子：
3.3
作者：
Boos, Anja M.;Loew, Johanna S.;Beier, Justus P.
通讯作者：
Beier, Justus P.
影响因子：
14
作者：
Goldstein, AS;Juarez, TM;Mikos, AG
通讯作者：
Mikos, AG
影响因子：
5.3
作者：
Arkudas A;Tjiawi J;Saumweber A;Beier JP;Polykandriotis E;Bleiziffer O;Horch RE;Kneser U
通讯作者：
Kneser U