Expression of VEGF in Peripheral Serum is a Possible Prognostic Factor in Bone-Regeneration via Masquelet-Technique—A Pilot Study

Journal of Clinical Medicine

卷:10

Christopher Child¹  Fabian Westhauser¹  Michael C. Tanner¹  Christian Fischer¹  Gerhard Schmidmaier¹  Patrick Haubruck¹  Sonja Boxriker²  Arash Moghaddam² 

[1] Center for Orthopedics, Trauma Surgery and Paraplegiology, Heidelberg University Hospital, D-69118 Heidelberg, Germany;

[2] Center of Orthopedics, Trauma & Sports medicine, Aschaffenburg-Alzenau Hospital, 63739 Aschaffenburg, Germany;

关键词: non-union;    Masquelet-technique;    induced membrane;    bone regeneration;    VEGF;   

DOI  :  10.3390/jcm10040776

来源: DOAJ

【 摘 要 】

Two-step Masquelet-technique established a new procedure in the treatment of osseous defects, addressing prerequisites postulated by the “diamond concept”. Increase in blood perfusion and growth factors are enhanced by the “Masquelet-membrane”. To describe this, we measured serum levels of Vascular Endothelial Growth Factor (VEGF) of patients with atrophic non-unions of long bones undergoing Masquelet-technique. From over 500 non-union patients undergoing Masquelet-technique with prospective follow-up we randomly selected 30 patients. 23 were included, 7 lost to follow-up or excluded because of incomplete data. Serum was drawn at specified intervals before and after surgery. Patients were followed for at least 6 months after step 2. Classification into both groups was performed according to radiological results and clinical outcome 6 months after step 2. Concentration of VEGF in patients’ serum was performed via ELISA. 14 achieved osseous consolidation (responder group), 9 cases did not (non-responder). Responders showed a significant increase of serum-VEGF in the first and second week when compared to the preoperative values of step 1. Non-responders showed a significant increase of VEGF in the second week after Steps 1 and 2. Comparison of groups showed significantly higher increase of serum-VEGF week2 after step 1 and preoperative to step 2 for responders. Results show one possibility of illustrating therapeutic progress by monitoring growth factors and possibly allowing prognostic conclusions thereof. This might lead to a more targeted treatment protocol.

【 授权许可】

Unknown