Chinese Journal of Tissue Engineering Research ›› 2016, Vol. 20 ›› Issue (2): 162-166.doi: 10.3969/j.issn.2095-4344.2016.02.002

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Early diagnosis of experimental bone nonunion: measurement of N-terminal telopeptide of type I collagen and quantitative CT determination of bone mineral density

Lin Jian-ping1, 2, Shen Ning-jiang1, Shi Zhan-jun2, Wang Jian2, Xiao Jun2, Wu Duo-neng1, Zhang Wu1   

  1. 1Department of Joint Surgery, Hainan General Hospital, Haikou 570311, Hainan Province, China; 2Department of Joint Surgery, Nanfang Hospital of South Medical University, Guangzhou 510515, Guangdong Province, China
  • Received:2015-11-11 Online:2016-01-08 Published:2016-01-08
  • About author:Lin Jian-ping, Studying for doctorate, Chief physician, Department of Joint Surgery, Hainan General Hospital, Haikou 570311, Hainan Province, China; Department of Joint Surgery, Nanfang Hospital of South Medical University, Guangzhou 510515, Guangdong Province, China
  • Supported by:

    the Natural Science Foundation of Hainan Province, No. 808212

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Abstract:

BACKGROUND: Currently, X-ray examination is mainly used for diagnosis of nonunion. However, this method that relies only on the clinician’s experience and degree of callus mineralization has less accuracy because it is vulnerable to projection, processing conditions and subjective factors.
OBJECTIVE: To establish an animal model of nonunion and to detect the variation of biochemical markers and bone mineral density.
 
METHODS: Twenty New Zealand white rabbits were randomly divided into two groups, and bone defect and fracture models were made in the midshaft of the forearm radius, respectively. X-ray examination of the forearm, quantitative CT measurement of bone mineral density and serological test were carried out before and at 2, 3, 4, 5, 6, 7, 8, 10, 12 weeks after surgery.
RESULTS AND CONCLUSION: Postoperative X-ray films showed that the in the bone defect group, a little callus formed in three rabbits at 2 weeks, the callus formed stably at 5 weeks, but there was still no healing at 8 weeks; in the fracture group, the fracture line was blurred at 2 weeks and a large number of calluses formed at 6-8 weeks. Compared with the fracture group, the value of bone mineral density in the bone defect group began to decrease significantly at 5 weeks after surgery. Results from the serological test showed that in the bone defect group, the activity of bone-specific alkaline phosphatase increased after surgery, reached peak at 4 weeks, began to decrease at 5 weeks and became stable at 6 weeks; the activity of tartrate-resistant acid phosphatase 5b increased after surgery, peaked at 4 weeks, then decreased and stabilized basically; the expression of N-terminal telopeptide of type I collagen decreased significantly at 5 weeks after surgery and became stable at 6 weeks. These findings indicate that the systematic monitoring of changes in bone mineral density and biochemical indicators such as bone-specific alkaline phosphatase, tartrate-resistant acid phosphatase 5b and type I collagen N-terminal telopeptides may help to reflect the early progress of rabbit nonunion.