Allogeneic cortical bone complex for fracture nonunion and bone defects

doi:10.3969/j.issn.2095-4344.2013.51.007

Abstract

Abstract:

BACKGROUND: Dried allogeneic cortical bone has a porous structure, with uniform and interconnected holes at an aperture of about 200 μm, and the morphological structure is very similar to human bone.
OBJECTIVE: To study the clinical effects of the compound graft of allogeneic cortical bone, bone marrow mesenchymal stem cells and bone morphogenetic protein in the treatment of fracture nonunion and traumatic bone defects.
METHODS: Thirty-three patients with traumatic bone defects were enrolled, including 19 males and 14 females, aged 26-85 years. First, autologous bone marrow mesenchymal stem cells were isolated and cultured. Then allogeneic cortical bone as scaffold material was implanted with bone marrow mesenchymal stem cells and bone morphogenetic protein to synthesize allogeneic cortical bone complex that was grafted into bone defects (20-45 g per case).
RESULTS AND CONCLUSION: All the patients were followed up for 6 months to 2.5 years. According to the Mankin and Komender standard evaluation of allogeneic bone transplantation, there were 32 cases with satisfaction and one case with dissatisfaction. The X-ray films at reexamination showed that 32 patients had bone healing, with fresh fracture healing time of 2-7 months and old fracture healing time of 4-9 months. The allogeneic cortical bone complex began to be fused with autologous bone through creeping substitution 6-9 weeks after transplantation. One case, which had delayed infection, had bone union by removing internal fixation, placing irrigating tube and grafting after local stability. During the follow-up of 25 months, no relapse was found. Another case had nonunion because of plate loosening, and received secondary internal fixation and autogenous bone graft. The allogeneic cortical bone complex exhibits no evident side effects and is effective in the treatment of fracture nonunion and traumatic bone defects.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: biocompatible materials, tissue engineering, stem cells, bone morphogenetic proteins

CLC Number:

R318

Wang Bin, Lü Hao-ran, Wang Wei-xiong, Li Sheng. Allogeneic cortical bone complex for fracture nonunion and bone defects[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(51): 8821-8826.

Figures/Tables 3

References

[1]San Julian M,Valenti A. Bone transplant.An Sist Sanit Navar. 2006; 29 Suppl 2:125-136.

[2]田长庆,李振宇,周文钰,等.同种异体骨与自体骨混合移植在脊柱融合中的应用[J].中国修复重建外科杂志,2009,23(5):517-519.

[3]Miura Y,Imagama S,Yoda M,et al.Is local bone viable as asource of bone graft in posterior lumbar interbody fusion.Spine (Phila Pa 1976).2009;28(20):2386-2389.

[4]Ebelke DK,Asher MA,Neff JR,et al.Survivorship analysis of VSP spine instrumentation in the treatment of thoracolumbar and lumbar burst fractures.Spine (Phila Pa 1976).2009;16 (8 Suppl):S428-432.

[5]Menon DK,Dougall TW,Pool RD,et al.Augmentative Ilizarov external fixation after failure of diaphyseal union with intramedullary nailing.J Orthop Trauma.2012;16:491-497.

[6]滕勇,徐建丽,李旭升,等.人骨髓基质干细胞的单细胞克隆培养与鉴定[J].中国组织工程研究,2012,16(10):1742-1747.

[7]Mankin HJ,Gebhardt MC,Tomford WW.The use of frozen cadaveric allografts in the management of patients with bone tumors of the extremities.Orthop Clin North Am.1987;18(2): 275-289.

[8]Komender J,Malczewska H,Komender A.The rapeutic effects of transplantation of lyophilized and radiation-sterilized, allogeneic bone. Clin Orthop Relat Res.1991;(272):38-49.

[9]朱江涛,卫小春.股骨粗隆间骨折分型[J].实用骨科杂志,2007, 13(7):410-413

[10]Lacerda SA,Lanzoni JF,Bombonato-Prado KF,et al. Osteogenic potential of autogenous bone associated with bone marrow osteoblastic cells in bony defects: a histomorphometric study.Implant Dent.2009;18(6):521-529.

[11]Veis A,Kougias K,Tsirlis A,et al.Evaluation of the osteogenic potential in experimental defects, with and without bone marrow, in the rabbit tibia: a pilot study.Int J Oral Maxillofac Implants.2009;24(6):1054-1060.

[12]Erggelet C,Kreuz PC,Mrosek EH,et al.Autologous chondrocyte implantation versus ACI using 3D-bioresorbable graft for the treatment of large full-thickness cartilage lesions of the knee.Arch Orthop Trauma Surg.2010;130(8):957-964.

[13]Veis A,Kougias K,Tsirlis A,et al.Evaluation of the osteogenic potential in experimental defects, with and without bone marrow, in the rabbit tibia: a pilot study.Int J Oral Maxillofac Implants.2009;24(6):1054-1060.

[14]Matsuo A,Chiba H,Takahashi H,et al.Clinical application of a custom-made bioresorbable raw particulate hydroxyapatite/ poly-L-lactide mesh tray for mandibular reconstruction. Odontology. 2010;98(1):85-88.

[15]王斌,贺西京,历强.嗅鞘细胞联合甲基强的松龙对大鼠脊髓损伤区神经中丝表达的影响[J].中华创伤杂志,2011,27(4):370-374．

[16]王斌,贺西京,历强,等.不同纯化方法体外培养人胚嗅球嗅鞘细胞[J].四川大学学报:医学版,2008,39(6):1023-1026.

[17]Niemeyer P,Schanberger TS,Hahn J,et al.Xenogenic transplantation of human mesenchymal stem cells in a critical size defect of the sheep tibia for bone regeneration.Tissue Eng Part A.2010;16(1):33-43.

[18]Kanczler JM,Ginty PJ,White L,et al.The effect of the delivery of vascular endothelial growth factor and bone morphogenic protein-2 to osteoprogenitor cell populations on bone formation. Biomaterials.2010;31(6):1242-1250.

[19]Zhu L,Chuanchang D,Wei L,et al.Enhanced healing of goat femur-defect using BMP7 gene-modified BMSCs and load-bearing tissue-engineered bone. J Orthop Res. 2010; 28(3):412-418.

[20]孔志刚,田德虎,于海泉,等.同种异体松质骨复合自体红骨髓移植治疗创伤性骨缺损[J].中国修复重建外科杂志,2008,22(10): 1251-1254.