Fibrin glue/bone morphogenetic protein complex plus slow-release gentamicin for repairing infected bone defects in rabbits / 中国组织工程研究

ABSTRACT

BACKGROUND: Chronic osteomyelitis is difficult to manage clinically, and two or more operations were commonly needed. No satisfactory method for one-stage repair has been currently available.OBJECTIVE: To examine the possibility of using fibrin glue(FG) as the common carrier for both bone morphogenetic protein(BMP) and gentamicin for one-stage repair of infected bone defects.DESIGN: A completely randomized controlled experiment.SETTING: Center of Orthopaedic Surgery, Lanzhou General Hospital of Lanzhou Area Command of of Chinese PLA.MATERIALS The experiment was conducted using 48 healthy adult Chinchilla rabbits of either sex on normal diet with body mass of 1.9 to 2.4 kg,provided by the Institute of Biological Products, Lanzhou, Gansu Province.INTERVENTIONS: Animal models of chronic osteomyelitis were established in 48 Chinchilla rabbits, and after thorough debriding of the wounds,an elongated semicircular bone defect was induced 1.5 cm to the medial proximal metaphysis in the tibias. Three treatments were subsequently given with FG, MP and gentamicin complex(Group A), FG/BMP complex(Group B), and nothing(control group, Group C), respectively.MAIN OUTCOME MEASURES: The general conditions of the rabbits were observed postoperatively. Bacterial culture of the bone specimen, bacterial counting, X-ray and histological examination were performed.RESULTS: Rabbits in Group A exhibited obviously better infection control and greater regenerated bone mass than those in Group B, and no significant difference was noted in infection control between Groups B and C, the latter group showing poor bone defect repair.CONCLUSIONS: FG, BMP and gentamicin complex helps to control infection and promotes bone formation, and can be used to repair bone defects caused by infection and open injury with severe contamination.