Yasemin BALDIK, Ufuk TALU, Levent ALTINEL, Hatice BİLGE, Aykaç Gülçin TOKER

Nitrik oksitin kemik iyileşmesi üzerine olan etkisinin radyolojik incelenmesi: Sıçanlarda deneysel çalışma

Amaç: Nitrik oksitin (NO) kemik iyileşmesi üzerindeki etkisi araştırıldı. Çalışma planı: Erişkin ve aynı yaşta 20 adet Sprague-Dawley türü sıçanın femurlarında kritik büyüklükte segmental defekt modeli kullanıldı. Diafiz ortasında diafiz çapının yaklaşık iki katı büyüklüğünde (5 mm) standart defekt oluşturuldu. 23x3x4 mm boyutunda polietilen plak ve 1.2 mm çaplı piva çivileriyle stabil osteosentez yapıldı. Defekt bölgesi greftlenmesinde kontrol grubunda aynı tür sıçanın femur ve tibialarından elde edilen demineralize kemik matriksi (DKM), deney grubunda ise NO’nun depo şekli gibi davranan nitrozoalbumin ile muamele edilen DKM kullanıldı. Ameliyattan sonra 1, 3, 5, 6 ve 10. haftalarda yapılan radyolojik değerlendirmelerde kallus oluşumu ve kaynama üç ayrı gözlemci tarafından değerlendirildi. Sonuçlar: Radyolojik değerlendirmede gözlemciler arası güvenilirlik için korrelasyon katsayısı anlamlı (r=0.97) bulundu. Onuncu haftada kontrol grubunda hiçbir hayvanda %100 kallus oluşumu ve kaynama görülmezken, deney grubunda iki hayvanda %100’e yakın kallus oluşumu, altı hayvanda kaynama gözlendi. Yeni kemik oluşumu görülen ortalama defekt alanı kontrol grubunda %43, deney grubunda %83 bulundu. Her iki gruptaki kemik oluşumuna ait veriler değişkenlerin parametrik olmayan analizi (Kruskal-Wallis H Testi) yöntemiyle değerlendirildi ve fark istatistiksel olarak anlamlı bulundu (p=0.022). Çıkarımlar: Kırık iyileşmesinin erken döneminde ortama verilen NO’nun iyileşmeyi ve yeni kemik oluşumunu olumlu yönde etkilediği görüldü.

Anahtar Kelimeler:

Nitrik oksit, Kemik ve kemikler, Neovaskülarizasyon, fizyolojik, Kemik oluşumu, Kemik yenilenmesi, Apoptoz

Radiographic evaluation of the effect of nitric oxide on bone healing: An experimental study

Methods:Twenty adult Sprague-Dawley rats were used in a critical-size, segmental femoral defect model. A standard 5 mm segmental defect, approximately twice the diameter of the diaphysis, was created in the middle of the shaft. A polyethylene plate (23x3x4 mm) and L3-size postdental screws (1.2 mm in diameter) were used for rigid fixation. The defect was grafted using demineralized rat-bone (femur and tibia) matrix (DBM) in the control group, and DBM treated with nitrosoalbumin (an active NO congener) in the study group. Serial radiographs were obtained at 1, 3, 5, 6, and 10 weeks postoperatively. Bone formation and union were scored by three independent observers. Results: The interobserver reliability study for radiographic scoring yielded an intraclass correlation coefficient of r=0.97. At the end of the 10th postoperative week none of the rats in the control group had 100% callus formation and union, whereas nearly 100% callus formation and union were observed in two and six study animals, respectively. Similarly, the calculated median values for the defect area occupied by new bone were 43% and 83% in the control and study groups, respectively. Analysis of data on bone formation showed a statistically significant difference between the two groups (Kruskal-Wallis H test, p=0.022). Conclusion: Significant difference in radiologic results suggest that NO may promote healing and new bone formation when given in the early phase of bone healing.

Keywords:

Nitric Oxide, Bone and Bones, Neovascularization, Physiologic, Osteogenesis, Bone Regeneration, Apoptosis,

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