Comparison between the induced membrane technique and distraction osteogenesis in treating segmental bone defects: An experimental study in a rat model


Autoři: Zhen Shen aff001;  Haixiong Lin aff001;  Guoqian Chen aff003;  Yan Zhang aff001;  Zige Li aff001;  Ding Li aff001;  Lei Xie aff004;  Yue Li aff005;  Feng Huang aff005;  Ziwei Jiang aff005
Působiště autorů: First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China aff001;  Department of Orthopaedics, First Affiliated Hospital of Hunan Traditional Chinese Medical College, Zhuzhou, Hunan, China aff002;  Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China aff003;  Tropical Medicine Institute, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China aff004;  Department of Orthopaedics, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226839

Souhrn

Previous studies have suggested that treatment plans for segmental bone defects (SBDs) are affected by the bone defect sizes. If the selected treatment was not the most appropriate, it would not contribute to bone healing, but increase complications. The induced membrane technique (IM) and distraction osteogenesis (DO) have been proved to be effective in treating SBDs. However, the differences between the two in therapeutic effects on SBDs with different sizes are still unclear. Thus, we aimed to observe the effects of IM and DO on different sizes of SBDs and to further determine what method is more appropriate for what defect size. Rat models of 4-, 6-and 8-mm mid-diaphyseal defects using IM and DO techniques were established. X-rays, micro-CT, histological and immunohistochemical examinations were performed to assess bone repair. Faster bone formation rate, shorter treatment duration, higher expressions of OPN and OCN and higher parameters of bone properties including bone mineral density (BMD), bone volume/total tissue volume (BV/TV), mineral apposition rate (MAR) and mineral surface/bone surface (MS/BS) were found in 4-mm SBDs treated with DO than in those with IM treatment. However, the results were reversed and IM outperformed DO in bone repair capacity for 8-mm SBDs, while no significant difference emerges in the case of 6-mm SBDs. This study suggests that the therapeutic effects of IM and DO may be subjected to sizes of bone defects and the best treatment size of defects is different between the two. For small-sized SBDs, DO may be more suitable and efficient than IM, but IM has advantages over DO for over-sized SBDs, while DO and IM show similar bone repair capability in moderate-sized SBDs, which would offer a new insight into how to choose DO and IM for SBDs in clinical practice and provide references for further clinical research.

Klíčová slova:

Bone development – Bone imaging – Histology – Ossification – Surgical and invasive medical procedures – Tissue repair


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2019 Číslo 12