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Cyclic Distraction–Compression Dynamization Technique Enhances the Bone Formation During Distraction Osteogenesis

Background: Interfragmentary movements have benefits in the improvement of bone formation during distraction osteogenesis (DO). Although several clinical studies reported positive outcomes regarding the application of the cyclic distraction–compression (CDC) dynamization technique in cases with poor...

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Autores principales: Liu, Yanshi, Cai, Feiyu, Liu, Kai, Liu, Jialin, Zhang, Xiaoxu, Yusufu, Aihemaitijiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8806138/
https://www.ncbi.nlm.nih.gov/pubmed/35118057
http://dx.doi.org/10.3389/fbioe.2021.810723
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author Liu, Yanshi
Cai, Feiyu
Liu, Kai
Liu, Jialin
Zhang, Xiaoxu
Yusufu, Aihemaitijiang
author_facet Liu, Yanshi
Cai, Feiyu
Liu, Kai
Liu, Jialin
Zhang, Xiaoxu
Yusufu, Aihemaitijiang
author_sort Liu, Yanshi
collection PubMed
description Background: Interfragmentary movements have benefits in the improvement of bone formation during distraction osteogenesis (DO). Although several clinical studies reported positive outcomes regarding the application of the cyclic distraction–compression (CDC) dynamization technique in cases with poor bone formation during DO, they are mostly anecdotal without a detailed description. The purpose of this study was to investigate the effectiveness and potential mechanism of different amplitudes and rates of the CDC technique on bone regeneration in a rat femur DO model. Methods: A total of 60 adult male Sprague-Dawley rats underwent right femoral mid-diaphysis transverse osteotomy and were randomly and evenly divided into Control (no manipulation), Group1 (CDC therapy), Group2 (CDC therapy with larger amplitude), and Group3 (CDC therapy with a slower rate) after distraction. The CDC technique was performed during the middle phase of the consolidation period according to different protocols. Animals were sacrificed after 4 and 6 weeks of consolidation. The process of bone formation was monitored by digital radiographs, and the regenerate bone was evaluated by micro-computed tomography (micro-CT), biomechanical test, and histological analysis. The serum contents of hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) were measured by enzyme-linked immunosorbent assay (ELISA). Results: Bone regeneration after the CDC technique was improved significantly during DO. The digital radiograph, micro-CT, histomorphological analysis, and biomechanical evaluation showed better effects regarding volume, continuity, and mechanical properties of the regenerate bone in Group2 and Group3 when compared to Group1. The angiogenic and osteogenic markers were more highly expressed in Group2 and Group3 than in Group1 according to the immunohistochemical analysis. As for ELISA, the serum contents of HIF-1α and VEGF were also increased after the CDC technique, especially in Group2 and Group3. Conclusion: The CDC dynamization technique has benefits on the improvement of bone formation during DO, and the mechanism may be due to tissue hypoxia activating the HIF pathway followed by the augmentation of osteogenic–angiogenic coupling. Better outcomes may be achieved by moderately increasing the amplitude and slowing down the rate of the CDC technique.
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spelling pubmed-88061382022-02-02 Cyclic Distraction–Compression Dynamization Technique Enhances the Bone Formation During Distraction Osteogenesis Liu, Yanshi Cai, Feiyu Liu, Kai Liu, Jialin Zhang, Xiaoxu Yusufu, Aihemaitijiang Front Bioeng Biotechnol Bioengineering and Biotechnology Background: Interfragmentary movements have benefits in the improvement of bone formation during distraction osteogenesis (DO). Although several clinical studies reported positive outcomes regarding the application of the cyclic distraction–compression (CDC) dynamization technique in cases with poor bone formation during DO, they are mostly anecdotal without a detailed description. The purpose of this study was to investigate the effectiveness and potential mechanism of different amplitudes and rates of the CDC technique on bone regeneration in a rat femur DO model. Methods: A total of 60 adult male Sprague-Dawley rats underwent right femoral mid-diaphysis transverse osteotomy and were randomly and evenly divided into Control (no manipulation), Group1 (CDC therapy), Group2 (CDC therapy with larger amplitude), and Group3 (CDC therapy with a slower rate) after distraction. The CDC technique was performed during the middle phase of the consolidation period according to different protocols. Animals were sacrificed after 4 and 6 weeks of consolidation. The process of bone formation was monitored by digital radiographs, and the regenerate bone was evaluated by micro-computed tomography (micro-CT), biomechanical test, and histological analysis. The serum contents of hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) were measured by enzyme-linked immunosorbent assay (ELISA). Results: Bone regeneration after the CDC technique was improved significantly during DO. The digital radiograph, micro-CT, histomorphological analysis, and biomechanical evaluation showed better effects regarding volume, continuity, and mechanical properties of the regenerate bone in Group2 and Group3 when compared to Group1. The angiogenic and osteogenic markers were more highly expressed in Group2 and Group3 than in Group1 according to the immunohistochemical analysis. As for ELISA, the serum contents of HIF-1α and VEGF were also increased after the CDC technique, especially in Group2 and Group3. Conclusion: The CDC dynamization technique has benefits on the improvement of bone formation during DO, and the mechanism may be due to tissue hypoxia activating the HIF pathway followed by the augmentation of osteogenic–angiogenic coupling. Better outcomes may be achieved by moderately increasing the amplitude and slowing down the rate of the CDC technique. Frontiers Media S.A. 2022-01-18 /pmc/articles/PMC8806138/ /pubmed/35118057 http://dx.doi.org/10.3389/fbioe.2021.810723 Text en Copyright © 2022 Liu, Cai, Liu, Liu, Zhang and Yusufu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Liu, Yanshi
Cai, Feiyu
Liu, Kai
Liu, Jialin
Zhang, Xiaoxu
Yusufu, Aihemaitijiang
Cyclic Distraction–Compression Dynamization Technique Enhances the Bone Formation During Distraction Osteogenesis
title Cyclic Distraction–Compression Dynamization Technique Enhances the Bone Formation During Distraction Osteogenesis
title_full Cyclic Distraction–Compression Dynamization Technique Enhances the Bone Formation During Distraction Osteogenesis
title_fullStr Cyclic Distraction–Compression Dynamization Technique Enhances the Bone Formation During Distraction Osteogenesis
title_full_unstemmed Cyclic Distraction–Compression Dynamization Technique Enhances the Bone Formation During Distraction Osteogenesis
title_short Cyclic Distraction–Compression Dynamization Technique Enhances the Bone Formation During Distraction Osteogenesis
title_sort cyclic distraction–compression dynamization technique enhances the bone formation during distraction osteogenesis
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8806138/
https://www.ncbi.nlm.nih.gov/pubmed/35118057
http://dx.doi.org/10.3389/fbioe.2021.810723
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