AIM To present the incidence of heterotopic ossification after the use of recombinant human bone morphogenetic protein-7(rhB MP-7) for the treatment of nonunions.METHODS Bone morphogenetic proteins(BMPs) promote bone ...AIM To present the incidence of heterotopic ossification after the use of recombinant human bone morphogenetic protein-7(rhB MP-7) for the treatment of nonunions.METHODS Bone morphogenetic proteins(BMPs) promote bone formation by auto-induction. Recombinant human BMP-7 in combination with bone grafts was used in 84 patients for the treatment of long bone nonunions. All patients were evaluated radiographicaly for the development of heterotopic ossification during the standard assessment for the nonunion healing. In all patients(80.9%) with radiographic signs of heterotopic ossification, a CT scan was performed. Nonunion site palpation and ROM evaluation of the adjacent jointswere also carried out. Factors related to the patient(age, gender), the nonunion(location, size, chronicity, number of previous procedures, infection, surrounding tissues condition) and the surgical procedure(graft and fixation type, amount of rhB MP-7) were correlated with the development of heterotopic ossification and statistical analysis with Pearsons χ~2 test was performed.RESULTS Eighty point nine percent of the nonunions treated with rh BMP-7, healed with no need for further procedures. Heterotopic bone formation occurred in 15 of 84 patients(17.8%) and it was apparent in the routine radiologi-cal evaluation of the nonunion site, in a mean time of 5.5 mo after the rh BMP-7 application(range 3-12). The heterotopic ossification was located at the femur in 8 cases, at the tibia in 6, and at the humerus in οne patient. In 4 patients a palpable mass was present and only in one patient, with a para-articular knee nonunion treated with rhB MP-7, the size of heterotopic ossification affected the knee range of motion. All the patients with heterotopic ossification were male. Statistical analysis proved that patient's gender was the only important factor for the development of heterotopic ossification(P = 0.007). CONCLUSION Heterotopic ossification after the use of rh BMP-7 in nonunions was common but it did not compromise the final clinical outcome in most cases, and affected only male patients.展开更多
目的研究重组人骨形态发生蛋白-7(recombinant human bone morphogenetic proteins,rhBMP-7)对大鼠成骨细胞增殖和分化能力的影响。方法从SD大鼠取材进行原代培养,经碱性磷酸酶(alkaline phosphatase,ALP)和矿化结节检测鉴定为成骨细胞...目的研究重组人骨形态发生蛋白-7(recombinant human bone morphogenetic proteins,rhBMP-7)对大鼠成骨细胞增殖和分化能力的影响。方法从SD大鼠取材进行原代培养,经碱性磷酸酶(alkaline phosphatase,ALP)和矿化结节检测鉴定为成骨细胞后传代至第3代,接种至96孔培养板。分为A、B、C、D、E、F共6组,每组3个复孔,rhBMP-7浓度分别为0.000、0.500、1.000、5.000、10.000、50.000mg/L。应用四甲基偶氮唑盐(meth-yl thiazolyl tetrazolium,MTT)法及PNPP偶氮法,分析不同浓度rhBMP-7作用72h后对大鼠成骨细胞增殖和ALP活性的影响,应用单因素方差分析和LSD法统计数据。结果作用72h后,6种浓度rhBMP-7对大鼠成骨细胞ALP活性促进作用的差异有统计学意义(F=11.840,P=0.000),B组成骨细胞ALP活性高于A组,但差异无统计学意义(P=0.078),C、D、E、F组大鼠成骨细胞ALP活性均高于A组(P值均为0.000),rhBMP-7浓度为50.000mg/L时对ALP活性的影响最明显(P=0.000)。作用72h后6种浓度rhBMP-7对大鼠成骨细胞增殖影响的差异有统计学意义(F=2.726,P=0.026);rhBMP-7能促进大鼠成骨细胞的增殖和分化,同A组(rhBMP-7浓度为0.000mg/L)相比,当rhBMP-7浓度为50.000mg/L时并作用至第3天时,大鼠成骨细胞增殖最显著(P=0.000)。结论一定剂量的rhBMP-7明显促进了大鼠成骨细胞的增殖和分化。展开更多
基金The European Union(European Social Fund-ESF)Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework(NSRF)-Research Funding Program:Heracleitus Ⅱ
文摘AIM To present the incidence of heterotopic ossification after the use of recombinant human bone morphogenetic protein-7(rhB MP-7) for the treatment of nonunions.METHODS Bone morphogenetic proteins(BMPs) promote bone formation by auto-induction. Recombinant human BMP-7 in combination with bone grafts was used in 84 patients for the treatment of long bone nonunions. All patients were evaluated radiographicaly for the development of heterotopic ossification during the standard assessment for the nonunion healing. In all patients(80.9%) with radiographic signs of heterotopic ossification, a CT scan was performed. Nonunion site palpation and ROM evaluation of the adjacent jointswere also carried out. Factors related to the patient(age, gender), the nonunion(location, size, chronicity, number of previous procedures, infection, surrounding tissues condition) and the surgical procedure(graft and fixation type, amount of rhB MP-7) were correlated with the development of heterotopic ossification and statistical analysis with Pearsons χ~2 test was performed.RESULTS Eighty point nine percent of the nonunions treated with rh BMP-7, healed with no need for further procedures. Heterotopic bone formation occurred in 15 of 84 patients(17.8%) and it was apparent in the routine radiologi-cal evaluation of the nonunion site, in a mean time of 5.5 mo after the rh BMP-7 application(range 3-12). The heterotopic ossification was located at the femur in 8 cases, at the tibia in 6, and at the humerus in οne patient. In 4 patients a palpable mass was present and only in one patient, with a para-articular knee nonunion treated with rhB MP-7, the size of heterotopic ossification affected the knee range of motion. All the patients with heterotopic ossification were male. Statistical analysis proved that patient's gender was the only important factor for the development of heterotopic ossification(P = 0.007). CONCLUSION Heterotopic ossification after the use of rh BMP-7 in nonunions was common but it did not compromise the final clinical outcome in most cases, and affected only male patients.
文摘目的研究重组人骨形态发生蛋白-7(recombinant human bone morphogenetic proteins,rhBMP-7)对大鼠成骨细胞增殖和分化能力的影响。方法从SD大鼠取材进行原代培养,经碱性磷酸酶(alkaline phosphatase,ALP)和矿化结节检测鉴定为成骨细胞后传代至第3代,接种至96孔培养板。分为A、B、C、D、E、F共6组,每组3个复孔,rhBMP-7浓度分别为0.000、0.500、1.000、5.000、10.000、50.000mg/L。应用四甲基偶氮唑盐(meth-yl thiazolyl tetrazolium,MTT)法及PNPP偶氮法,分析不同浓度rhBMP-7作用72h后对大鼠成骨细胞增殖和ALP活性的影响,应用单因素方差分析和LSD法统计数据。结果作用72h后,6种浓度rhBMP-7对大鼠成骨细胞ALP活性促进作用的差异有统计学意义(F=11.840,P=0.000),B组成骨细胞ALP活性高于A组,但差异无统计学意义(P=0.078),C、D、E、F组大鼠成骨细胞ALP活性均高于A组(P值均为0.000),rhBMP-7浓度为50.000mg/L时对ALP活性的影响最明显(P=0.000)。作用72h后6种浓度rhBMP-7对大鼠成骨细胞增殖影响的差异有统计学意义(F=2.726,P=0.026);rhBMP-7能促进大鼠成骨细胞的增殖和分化,同A组(rhBMP-7浓度为0.000mg/L)相比,当rhBMP-7浓度为50.000mg/L时并作用至第3天时,大鼠成骨细胞增殖最显著(P=0.000)。结论一定剂量的rhBMP-7明显促进了大鼠成骨细胞的增殖和分化。
