Vascular endothelial growth factor for the treatment of femoral head osteonecrosis:An experimental study in canines

• 作者: Cristian Fink Georgios Dimakopoulos James R Bowers James R Urbaniak Lubna Khaldi Nikolaos Stefanou Zoe H Dailiana
• 来源期刊: 世界骨科杂志
• 学科: 医学
• 关键词: OSTEONECROSIS Vascular endothelial growth factor AVASCULAR necrosis FEMORAL head OSTEOGENESIS Animal model
• 年，卷（期）: 2018,（9）
• 页码范围: 120-129
• 页数: 10页
• 分类号: R

摘要

AIM To evaluate the treatment of osteonecrosis of the femoral head(ONFH)with the use of vascular endothelial growth factor(VEGF).METHODS In 30 mature beagles(6 groups of 5 beagles)ONFH was induced cryosurgically and one of the following solutions was administered locally in the femoral head(FH)in each group:Single injection of 500μg VEGF(t-VEGFμgroup);single injection of 500 ng VEGF(t-VEGFn group);continuous delivery of 500μg VEGF through osmotic micropump(t-VEGFpump-μgroup);continuous delivery of 500 ng VEGF through osmotic micropump(t-VEGFpump-n group);single injection of 0.9%sodium chloride(t-NS group),while one group that served as control group did not receive any local solution(No-t group).FHs were retrieved 12 wk postoperatively,underwent decalcification and hematoxylin/eosin and toluidine blue staining.In two canines per group,one half of FH was processed without decalcification and stained with modified Masson Trichrome.Histological sections were observed by light microscopy and measured with a semi-automatized bone histomorphometry system and Bone Volume/Total Volume(BV/TV),Marrow Volume/Total Volume(MaV/TV),and Trabecular Thickness(TbTh)were assessed.Standard and robust tests(Welch,Brown Forsythe)of analysis of variance along with multiple comparisons,were carried out among the categories.RESULTS The untreated(No-t)group had signs of osteonecrosis,whereas the VEGF groups revealed reversal of the osteonecrosis.Statistical analysis of the decalcified specimens revealed a significantly better BV/TV ratio and a higher TbTh between the VEGF treatment groups(except the t-VEGFn group)and the No-t group or the control t-NS group.Single dose 500μgVEGF group had significantly better BV/TV ratio and higher TbTh when compared to the No-t group(50.45±6.18 vs 29.50±12.27,P=0.002 and 151.44±19.07 vs 107.77±35.15,P=0.161 respectively)and the control t-NS group(50.45±6.18 vs 30.9±6.67,P=0.004 and 151.44±19.07 vs 107.14±35.71,P=0.151 respectively).Similar differences were found for the prolonged VEGF delive