Mechanistic study of the effect of flexible fixation and load-bearing stress environment on fracture healing and shaping

Q1 Health Professions

Animal models and experimental medicine Pub Date : 2024-07-08 DOI:10.1002/ame2.12448

Xingfu Li, Zhenhan Deng, Wei Lu

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Abstract

Background

The biomechanical environment created by suture-button fixation Latarjet is conducive to the healing and shaping of the transplanted coracoid, but its mechanism remains unclear. The latest research has found that the absence of stem cell chemokine (CXCL12) impeded bone regeneration in Sonic Hedgehog (SHH)-deficient animals. However, whether the biomechanical environment affects SHH and CXCL12 function has not been studied.

Methods

Rat fracture models were constructed to simulate stress environments under non-load-bearing and load-bearing conditions. The fracture healing and shaping, as well as the expression levels of SHH and CXCL12, were assessed through gross viewing, micro-computed tomography (micro-CT), and histochemical staining.

Results

Under flexible fixation, the relative bone volume (BV/TV) of rats exposed to the load-bearing stress environment was significantly higher than that of rats under a non-load-bearing stress environment (p ≤ 0.05). Adverse bone shaping was not observed in rats subjected to flexible fixation. The levels of SHH and CXCL12 in load-bearing rats exhibited significant elevation (p ≤ 0.05). Under a load-bearing stress environment, no significant difference was observed in the BV/TV between the flexible fixation group and the rigid fixation group (p ≥ 0.05), but there was excessive hyperplasia of the fracture callus in the rigid fixation group. The levels of SHH and CXCL12 in rats subjected to rigid fixation were significantly elevated (p ≤ 0.05).

Conclusions

Flexible fixation and load-bearing stress environment may contribute to bone healing and shaping by influencing the levels of SHH and CXCL12, suggested that this mechanism may be relevant to the healing and shaping of the transplanted coracoid after suture-button fixation Latarjet.

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柔性固定和承重应力环境对骨折愈合和塑形影响的机制研究。

背景：缝合扣固定Latarjet创造的生物力学环境有利于移植冠状骨的愈合和塑形，但其机制仍不清楚。最新研究发现，干细胞趋化因子（CXCL12）的缺失阻碍了音速刺猬（SHH）缺陷动物的骨再生。然而，生物力学环境是否会影响SHH和CXCL12的功能尚未得到研究：方法：构建大鼠骨折模型，模拟非承重和承重条件下的应力环境。方法：模拟大鼠骨折在非承重和承重条件下的应力环境，通过大体观察、显微计算机断层扫描（micro-CT）和组织化学染色评估骨折愈合和塑形情况以及 SHH 和 CXCL12 的表达水平：结果：在柔性固定条件下，大鼠在负重应力环境下的相对骨量（BV/TV）明显高于非负重应力环境下的相对骨量（P ≤ 0.05）。在接受柔性固定的大鼠身上没有观察到不良的骨塑形。负重大鼠的 SHH 和 CXCL12 水平明显升高（p ≤ 0.05）。在负重应力环境下，柔性固定组与刚性固定组的 BV/TV 无明显差异（p ≥ 0.05），但刚性固定组的骨折胼胝体过度增生。刚性固定组大鼠的SHH和CXCL12水平显著升高（P≤0.05）：结论：柔性固定和负重应力环境可通过影响SHH和CXCL12的水平促进骨愈合和塑形，这表明该机制可能与缝合-钮扣固定Latarjet后移植冠状突的愈合和塑形有关。

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