Hojení segmentálního defektu kosti po implantaci autogenního spongiózního kostního štěpu ve srovnání se skafoldem z hydroxyapatitu a 0,5 % kolagenu v kombinaci s mezenchymovými kmenovými buňkami
| Title in English | Healing of Large Segmental Bone Defect after Transplantation of Autogenous Cancellous Bone Graft and after Implantation of Resorbable Nanocomposite HAP-Collagen Scaffold Combined with Mesenchymal Stem Cells |
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| Authors | |
| Year of publication | 2012 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Objective: In clinical practice in children, the need of surgical management of large bone defects might be relatively frequently encountered (comminuted fractures, bone tumour, prolongation). Materials and Methods: In the miniature pig model iatrogenic segmental bone defect was created in the centre of diaphysis of the left femur. Osteotomized bone was stabilized using a titanium LCP and four 4.5 mm locking screws, leaving central plate hole empty. In animals of group A (n=6), the defect was filled with autogenous cancellous bone graft. In animals of group S (n=6), the segmental bone defect was filled with newly developed cylindrical mechanically self-supporting resorbable nanocomposite scaffold from hydroxyapatite and 0.5% collagen (1:1). In animals of group S+MSCs (n=6), the iatrogenic femoral defect was filled with the same hydroxyapatite and 0.5% collagen (1:1) scaffold seeded with mesenchymal stem cells (MSCs). Results and Discussion: The size of the formed callus was significantly larger (p<0.05) in animals after transplantation of an autogenous cancellous bone graft (group A, callus:cortex ratio of 1.77 +/- 0.33) compared to animals after implantation of the HAP and 0.5% collagen (1:1) (group S, callus:cortex ratio of 1.08 +/- 0.13), or in animals after implantation of the scaffold seeded with MSCs (group S+MSCs, callus:cortex ratio of 1.15 +/- 0.18). Unlike a scaffold in the shape of the original bone column, a freely placed autogenous cancellous bone graft may allow the newly formed tissue to spread more to the periphery of the ostectomy defect. Clinical Relevance: Unlike a scaffold in the shape of the original bone column, a freely placed autogenous cancellous bone graft may allow the newly formed tissue to spread more to the periphery of the ostectomy defect. Implanted cylindrical scaffolds (with and without MSCs) support callus formation directly in the center of original bone column in segmental femoral ostectomy, and can be successfully used in the treatment of large bone defects. |
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