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Dawei Zhang, Dong Huang, Yongjun Huang, Yuanhang Liu, Bochuan Lin, Chaoqun Yu, Yong Mou, Weichi Wu, Huiru Zhang, Hao Lin
(Department of Traumatic and Microsurgical, The Third Affiliated Hospital of Southern Medical University and Second People’s Hospital of Guangdong Province, Guangzhou, China (mainland))
Med Sci Monit 2014; 20:2394-2403
Large segmental bone defects caused by trauma, infection, or bone tumor resection are difficult to cure and have been a problem in the field of bone repair for decades. The objective of this study was to discuss the efficacy of combined therapy of free periosteum and bone allograft in treating bone defects and to provide a theoretical basis for clinical application of this therapy.
Material and Methods: A unilateral tibia cortical defect model in New Zealand white rabbits was established according to Girolamo method. Total 48 rabbits were randomized into 3 groups: a simple bone defect group (n=16), an autogenous bone graft group (n=16), and a periosteum and bone allograft combined therapy group (n=16). The efficacy was evaluated by imaging inspections and scoring, HE staining, and RT-PCR in postoperative weeks 2, 4, 8, and 12.
Results: The results of imaging and histopathological inspections in the study indicated that in postoperative weeks 4, 8, and 12 the experimental and control groups had statistically significant differences in Lane-Sandhu radiographic scoring and relative bone density when compared with the simple bone defect group (P<0.05). The RT-PCR results suggested that the expression of SPP-1, BMP-2, and VEGF in the experimental group was higher than in the control group (P<0.05) and the expression of Col Ia1 in the control group was higher than in the experimental group (P<0.05).
Conclusions: Efficacies of the combined therapy (periosteum combined with bone allografting) and the criterion standard therapy (autogenous bone grafting) are equivalent in treating bone defects in New Zealand white rabbits.