Reconstruction of large segmental bone defects in rabbit using the Masquelet technique with α-calcium sulfate hemihydrate

Journal of Orthopaedic Surgery and Research

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[1] 0000 0001 0348 3990, grid.268099.c, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China;0000 0004 0368 7493, grid.443397.e, Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China;grid.440657.4, Municipal Hospital Affiliated to Medical School of Taizhou University, Taizhou, China;0000 0004 0368 7493, grid.443397.e, Department of Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China;

关键词: Bone defect;    The Masquelet technique;    α-calcium sulfate hemihydrate;   

DOI  :  10.1186/s13018-019-1235-5

来源: publisher

【 摘 要 】

BackgroundLarge segmental bone defects can be repaired using the Masquelet technique in conjunction with autologous cancellous bone (ACB). However, ACB harvesting is severely restricted. α-calcium sulfate hemihydrate (α-CSH) is an outstanding bone substitute due to its easy availability, excellent biocompatibility, biodegradability, and osteoconductivity. However, the resorption rate of α-CSH is too fast to match the rate of new bone formation. The objective of this study was to investigate the bone repair capacity of the Masquelet technique in conjunction with isolated α-CSH or an α-CSH/ACB mix in a rabbit critical-sized defect model.MethodsThe rabbits (n = 28) were randomized into four groups: sham, isolated α-CSH, α-CSH/ACB mix, and isolated ACB group. A 15-mm critical-sized defect was established in the left radius, followed by filling with polymethyl methacrylate spacer. Six weeks after the first operation, the spacers were removed and the membranous tubes were grafted with isolated α-CSH, isolated ACB, α-CSH/ACB mix, or none. Twelve weeks later, the outcomes were evaluated by manual assessment, radiography, and spiral-CT. The histopathological and morphological changes were examined by H&E staining. The levels of alkaline phosphatase and osteocalcin were analyzed by immunohistochemistry and immunofluorescence staining.ResultsOur results suggest that the bone repair capacity of the α-CSH/ACB mix group was similar to the isolated ACB group, while the isolated α-CSH group was significantly decreased compared to the isolated ACB group.ConclusionThese results highlighted a promising strategy in the healing of large segmental bone defect with the Masquelet technique in conjunction with an α-CSH/ACB mix (1:1, w/w) as they possessed the combined effects of sufficient supply and low resorption.

【 授权许可】

CC BY