OBJECTIVE: To study the effect of platelet-rich plasma in the repair of bone defect. METHODS: Segmental bone defects of 1 cm were created in the mid-upper part of bilateral radius of 24 New Zealand white rabbits. One side was randomly chosen as the experimental side, which was filled with artificial bone with platelet-rich plasma (PRP). The other side filled with artificial bone without PRP as the control. After 2, 4, 8 and 12 weeks of implantation, the gross, radiological, histological observations, and computer graphic analysis were performed to investigate the bone healing of the defect in both sides. RESULTS: Two weeks after operation, new bone and fibrous tissue formation in both the experimental and the control sides were observed only in the areas adjacent to the cut ends of the host bone, but the amount of new tissue in the experimental side was much more than that in the control side. In the 4th and 8th weeks, the surface of the artificial bone was covered with a large amount of new bones, the artificial bone was bridged tightly with the host bone by callus in the experimental side, while new bone was limited mainly in the cut ends and was less mature in the control side. In the 12th weeks, bone defects were entirely healed in the experimental side, which were covered completely with cortical bone, while new bone formation was only observed in the ends of artificial bone and there were not continuous bone callus on the surface in the control side. CONCLUSION: Artificial bone with PRP is effective in the repair of segmental bone defects, and PRP could improve the healing of bone defect.
The primary results of five patients in whomthe block hydroxyapatite artificial bone (BHAB)used in maxillofacial plastic repair were reported. All incisions healed up with no evidence ofinfection. None of the implants was rejected norhad resorption changes. Satisfactory estheticaleffects were maintained. The results demonst-rated BHAB had a good biocampatibility andcould be used as a bone graft substitute inmaxillofacial plastic repair. This kind of material could be carved and contoured ...
Objective To evaluate the biomechanical stability of a newly-designed Y type pedicle screw (YPS) in osteoporotic synthetic bone. Methods The osteoporotic synthetic bone were randomly divided into 3 groups (n=20). A pilot hole, 3.0 mm in diameter and 30.0 mm in deep, was prepared in these bones with the same method. The YPS, expansive pedicle screw (EPS), and bone cement-injectable cannulated pedicle screw (CICPS) were inserted into these synthetic bone through the pilot hole prepared. X-ray film examination was performed after 12 hours; the biomechanical stability of YPS, EPS, and CICPS groups was tested by the universal testing machine (E10000). The test items included the maximum axial pullout force, the maximum running torque, and the maximum periodical anti-bending. Results X-ray examination showed that in YPS group, the main screw and the core pin were wrapped around the polyurethane material, the core pin was formed from the lower 1/3 of the main screw and formed an angle of 15° with the main screw, and the lowest point of the inserted middle core pin was positioned at the same level with the main screw; in EPS group, the tip of EPS expanded markedly and formed a claw-like structure; in CICPS group, the bone cement was mainly distributed in the front of the screw and was dispersed in the trabecular bone to form a stable screw-bone cement-trabecular complex. The maximum axial pullout force of YPS, EPS, and CICPS groups was (98.43±8.26), (77.41±11.41), and (186.43±23.23) N, respectively; the maximum running torque was (1.42±0.33), (0.96±0.37), and (2.27±0.39) N/m, respectively; and the maximum periodical anti-bending was (67.49±3.02), (66.03±2.88), and (143.48±4.73) N, respectively. The above indexes in CICPS group were significantly higher than those in YPS group and EPS group (P<0.05); the maximum axial pullout force and the maximum running torque in YPS group were significantly higher than those in EPS group (P<0.05), but there was no significant difference in the maximum periodical anti-bending between YPS group and EPS group (P>0.05). Conclusion Compared with EPS, YPS can effectively enhance the maximum axial pullout force and maximum rotation force in the module, which provides a new idea for the design of screws and the choice of different fixation methods under the condition of osteoporosis.
Objective To study the effect and complication of repairing depressed fracture of frontal part with hydroxylapatite particulate artificial bone. Methods From January 1994 to December 2002, 13 patients were all diagnosed as having depressed fracture of frontal part with clinical and X-ray examinations. Thesmall incision before the hair-edge or local small incision was made. After opening the incision, we performed creeping decollement. Then the hydroxylapatite particulate artificial bone was implanted into the sites of the depressed fracture. The effect and complication were observed with clinical and X-rayexaminations in all patients 1 week, 1 month, 3 months after operation.Results The quantity of hydroxylapatite implanted was 10-30g. Primary healing was obtained in all cases without any complication. All cases were followed up for 3 months. The contours of the frontal part were restored well. Conclusion It is a good method to repair depressed fracture of frontal part with hydroxylapatite particulate artificial bone.
Abstract To investigate the ectopic new bone formation following implantation of bovine hydroxyapatite Bio-oss together with free periosteum, 12 chabb: ch rabbits were selected. In 10 rabbits, Bio-oss block together with free periosteum was implanted in the gastrocnemius muscle of one leg randomly, and Bio-oss block alone was implanted in the same muscle of the other leg. In the other 2 rabbits, the periosteum was implanted into the gastrocnemius musle of both legs. Histologic examination and quantitative analysis of newbone formation were performed at 3 and 6 weeks postoperatively. The results showed that in the legs implanted bovine hydroxyapatite Bio-oss together with freeperiosteum, new bone formation began at 5th day after implantation. The area ofnew bone composed of 19.0% of the specimens at 3 weeks postoperatively. No boneformation through out the experimental period in Bio-oss block alone implantedlegs and also periosteum implanted legs. We concluded that bovine hydroxyapatite Bio-oss has a good capacity of osteoconduction. New bone can be formed after the implantation of hydroxyapatite combined with free periosteum.
目的 观察和评估活性多孔纳米复合人工颗粒骨纳米羟基磷灰石聚酰胺66（n-HA/PA66）骨修复下肢承重骨大块良性肿瘤性骨缺损的临床疗效。 方法 选取2007年12月－2011年5月，良性骨肿瘤行股骨和胫骨手术术后骨缺损较大，需植骨填充且植骨量＞20 g的患者67例。其中骨巨细胞瘤26例，纤维结构不良18例，骨囊肿10例，其他良性骨肿瘤13例。肿瘤刮除后瘤腔大小为3.0 cm×2.0 cm×1.5 cm～7.0 cm×3.0 cm×3.0 cm。全部患者行病灶刮除、瘤腔灭活、大量打压式植入n-HA/PA66人工骨，根据患者情况加用同种异体松质骨、含DBM人工骨，并根据皮质受累范围及厚度选择适当内固定。定期随访观察伤口愈合情况、患者肝肾功能、免疫指标、关节活动度及植骨处愈合情况。 结果 67例患者全部获得随访，随访时间7～45个月，平均31.3个月。所有患者伤口均I/甲愈合，术后无肝、肾功能损害，无免疫相关疾病发生。患者植骨愈合时间为术后3～9个月，平均4.6个月，愈合率95.2%。术后骨巨细胞瘤患者局部复发3例，均经再次手术，随访未再复发。 结论 n-HA/PA66颗粒骨可作为下肢承重骨大块良性肿瘤性骨缺损的植骨填充材料。
ObjectiveTo investigate the mechanism of early vascularization of the tissue engineered bone in the treatment of rabbit radial bone defect by local injection of angiopoietin 2 (Ang-2).MethodsForty-eight New Zealand white rabbits were established unilateral 1.5 cm long radius defect models. After implantation of hydroxyapatite/collagen scaffolds in bone defects, the rabbits were randomly divided into 2 groups: control group (group A) and Ang-2 group (group B) were daily injected with 1 mL normal saline and 1 mL saline-soluble 400 ng/mL Ang-2 at the bone defect within 2 weeks after operation, respectively. Western blot was used to detect the expressions of autophagy related protein [microtubule associated protein 1 light chain 3 (LC3), Beclin-1], angiogenesis related protein [vascular endothelial growth factor (VEGF)], and autophagy degradable substrate protein (SQSTMl/p62) in callus. X-ray films examination and Lane-Sandhu X-ray scoring were performed to evaluate the bone defect repair at 4, 8, and 12 weeks after operation. The rabbits were sacrificed at 12 weeks after operation for gross observation, and the angiogenesis of bone defect area was observed by HE staining.ResultsWestern blot assay showed that the relative expressions of LC3-Ⅱ/LC3-Ⅰ, Beclin-1, and VEGF in group B were significantly higher than those in group A, and the relative expression of SQSTMl/p62 was significantly lower than that in group A (P<0.05). Radiographic and gross observation of specimens showed that only a few callus were formed in group A, the bone defect was not repaired; more callus were formed and complete repair of bone defect was observed in group B. The Lane-Sandhu scores in group B were significantly higher than those in group A at 4, 8, and 12 weeks after operation (P<0.05). HE staining showed that the Harvard tubes in group B were well arranged and the number of new vessels was significantly higher than that in group A (t=–11.879, P=0.000).ConclusionLocal injection of appropriate concentration of Ang-2 may promote early vascularization and bone defect repair of tissue engineered bone in rabbits by enhancing autophagy.
There is a great hope to treat long bone defects with bioactive artificial bone constructed by osteoblasts and biomaterials, in which the key point is to provide an optimum environment for the normal function of osteoblasts. The cellular sociological characteristics of osteoblasts were summarized and it was suggested that the ideal bioactive artificial bone should be composed of inorganic and organic materials together with cellular components such as osteoblasts and vascular endothelial cells, and combined with control release of growth factors, following its implantation it could be vascularized very soon and merged with the host bone by bony consolidation.
Objective To investigate the cl inical efficacy of the cancellous granule-type calcium phosphate cement in repair bone defect. Methods Between July 2008 and July 2009, 35 patients (42 l imbs) with fractures, nonunion, and benign bone tumor were treated with cancellous granule-type calcium phosphate cement. There were 32 males and 3 females,with an age range from 9 to 73 years (median, 41 years), including 24 l imb fractures (19 cases), 4 osteotomy for deformity of ulna and radius (2 cases), 2 femur intertrochanteric bony cysts (2 cases), 3 enchondroma (3 cases), 5 bone defect at donor il ium (5 cases), 3 nonunion (3 cases), and 1 lumbar spinal stenosis (1 case). The size of bone defect was 1-5 cm. Bone defect was repaired with cancellous granule-type calcium phosphate cement (1-5 g). Results All cases were followed up 8-23 months (13.7 months on average). Thirty-nine incisions (32 cases) healed by first intention and the suture was removed after 10-14 days. Incision dehiscence occurred in 2 cases, and wounds healed after second debridement and removal of artificial bone. Exudation of incision occurred in 1 case, and wound healed after symptomatic treatment. No local red swell ing, higher temperature, maculopapule, and ulceration of skin occurred at implantation site. X-ray films showed that bone graft fusion was achieved and bone defect was radically repaired at 6 months after operation and artificial bone was absorbed completely at 12 months. Conclusion Cancellous granule-type calcium phosphate cement can be used as a new graft bone material, which is suitable for defect fill ing after traumatic fracture, benign bone tumors, and il iac bone donor.