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【medical-news】犬尺骨部分骨缺损愈合疗效的改善
Jones CB, Sabatino CT, Badura JM, Sietsema DL, Marotta JS
J Orthop Trauma. 2008 Sep;22:550-9
http://www.ncbi.nlm.nih.gov/sites/entrez
OBJECTIVES: A validated canine critical-sized segmental defect model was used to compare efficacy of volumetric ratios of recombinant human bone morphogenetic protein-2 (rhBMP-2)/absorbable collagen sponge (ACS) with cancellous allograft bone or biphasic calcium phosphate ceramic granules using radiographic, biomechanical, and histologic analyses.
METHODS: Eighteen mixed-breed hounds received bilateral critical-sized ulnar segmental defects. The six treatment groups included 1:5, 1:2, and 1:1 volumetric ratios of rhBMP-2/ACS to cancellous allograft chips; a 1:1 volumetric ratio of rhBMP-2/ACS to biphasic calcium phosphate ceramic granules; iliac crest autograft alone; and cancellous allograft chips alone (n = 6 ulna per group). Animals were euthanized at 12 weeks and analyzed by radiography, torsion testing, and histology.
RESULTS: rhBMP-2/ACS groups demonstrated higher radiographic union than autograft or allograft at 12 weeks. Both treatment groups receiving a 1:1 ratio demonstrated union rates of 100% (12/12 ulna) compared with 17% (1/6) and 0% (0/6) for autograft and allograft, respectively. Torsion testing to failure demonstrated significant increases in maximum torque for all rhBMP-2 groups compared with autograft, but no differences between the rhBMP-2 groups. Ulnae treated with the 1:1 volume ratio of rhBMP-2/ACS to ceramic had the highest histologic union grades followed by 1:1 and 1:2 volume ratios of rhBMP-2/ACS to allograft.
CONCLUSIONS: In this study, efficacy of the treatment correlated with the ratio of rhBMP-2/ACS to allograft. As volume of rhBMP-2/ACS decreased below a 1:1 volume ratio, the overall efficacy decreased, thus indicating a potential limit to extending rhBMP-2/ACS past a 1:1 volumetric ratio in large segmental defects. Furthermore, ceramic was found to be a successful replacement for cancellous allograft bone at a 1:1 volumetric ratio. Clinical application using graft expanders or bone void fillers with rhBMP-2 should be used carefully and requires further investigation.
本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Improved Healing Efficacy in Canine Ulnar Segmental Defects With Increasing Recombinant Human Bone Morphogenetic Protein-2/Allograft Ratios
犬尺骨部分骨缺损愈合疗效的改善与重组人骨形态发生蛋白-2/同种异体移植比率升高相关
Abstract:
摘要
Objectives: A validated canine critical-sized segmental defect model was used to compare efficacy of volumetric ratios of recombinant human bone morphogenetic protein-2 (rhBMP-2)/absorbable collagen sponge (ACS) with cancellous allograft bone or biphasic calcium phosphate ceramic granules using radiographic, biomechanical, and histologic analyses.
目标：使用一个经验证的犬临界尺寸的骨缺损模型来比较重组人骨形态发生蛋白-2(rhBMP-2)/可吸收胶原海绵(ACS)的体积比，可吸收胶原海绵(ACS)由同种异体松质骨或双相磷酸钙陶瓷颗粒组成。实验比较过程中使X线，生物力学和组织学分析。
Methods: Eighteen mixed-breed hounds received bilateral critical-sized ulnar segmental defects. The six treatment groups included 1:5, 1:2, and 1:1 volumetric ratios of rhBMP-2/ACS to cancellous allograft chips; a 1:1 volumetric ratio of rhBMP-2/ACS to biphasic calcium phosphate ceramic granules; iliac crest autograft alone; and cancellous allograft chips alone (n = 6 ulna per group). Animals were euthanized at 12 weeks and analyzed by radiography, torsion testing, and histology.
方法： 在18只混合繁殖猎犬中建立双侧临界尺寸的尺骨缺损模型。6个治疗组包括：重组人骨形态发生蛋白/可吸收胶原海绵的体积比为1:5、1:2和1:1的同种异体松质骨片；体积比为1:1的双相磷酸钙陶瓷颗粒；自体髂嵴单独移植；和同种异体松质骨移植（每组6个尺骨）。12个星期后处死动物，并进行X光，扭转试验，和组织学检测。
Results: rhBMP-2/ACS groups demonstrated higher radiographic union than autograft or allograft at 12 weeks. Both treatment groups receiving a 1:1 ratio demonstrated union rates of 100% (12/12 ulna) compared with 17% (1/6) and 0% (0/6) for autograft and allograft, respectively. Torsion testing to failure demonstrated significant increases in maximum torque for all rhBMP-2 groups compared with autograft, but no differences between the rhBMP-2 groups. Ulnae treated with the 1:1 volume ratio of rhBMP-2/ACS to ceramic had the highest histologic union grades followed by 1:1 and 1:2 volume ratios of rhBMP-2/ACS to allograft.
结果： 在12周时，重组人骨形态发生蛋白/可吸收胶原海绵组放射线显示骨连接高于自体移植组和同种异体移植组。与自体移植组的17%愈合率（1/6尺骨）和同种异体移植组的0%愈合率（0/6尺骨）相比，1:1体积比治疗组愈合率达到100%（12/12尺骨）。疲劳扭转试验结果显示所有rhBMP-2组相比自体移植组的最大扭矩力增高，但rhBMP-2组之间无差异。1:1体积比的rhBMP-2/ACS组组织学愈合级别最高，其次是1:1和1:2体积比的rhBMP-2/ACS的同种异体移植组。
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作者:admin@医学,生命科学 2011-05-05 16:58
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