In Vivo Therapeutic Studies Of Extracorporeal Shock Wave Comblined Fibrin Glue With Multiple Bone Growth Factors For Defect Or Delayed Osseous Union

Objective：to evaluate the effect of Extracorporeal Shock Wave combined percutaneous injection of enhanced fibrin glue loaded bone growth factor in accelerating the bone defect healing and promoting osteogenesis process.Methods:48 radius model rabbits were randomly divided into four groups. Group A rabbits were treated with ESW; Group B rabbits were treated with ESW combined with FG. Group C rabbits were treated with ESW combined with FG/rhBMP-2/rhbFGF. Group D rabbits were treated with ESW combined with FG/rhBMP-2/rhbFGF/rhVEGF. After a combination therapy of 8 wk, conventional X-ray radiography, optical inspection organization form and biomechanical test were applied to evaluate the therapeutic effect.Results:compared with the group B, the X-ray group C showed that the fracture line was fuzzy, bony callus area began to increased, fracture end range reduced. The histomorphology showed that cartilage began to form, cartilage cell began to proliferate actively, and new blood vessels were forminge surrounding fibrous connective tissue. Biomechanical determination found there was no statistical significance between the two groups (p>0.05).FG/rhBMP-2/rhbFGF+ESW group showed the fracture line was still fuzzy, bony callus disappeared and apparent proliferative bone trabecula, and biomechanical results showed there was statistical significance between the two groups compared to the group B p<0.01) FG/rhBMP-2/rhbFGF/rhVEGF+ESW group showed the fracture line was slightly fuzzy, apparent proliferative bone trabecula in 4w, and in 8w, the fracture line was disappeared and moulding of healing is good. The histomorphology showed that the distribution is filled with fibrous connective tissue and many bone tissue. biomechanical results showed it can resistance to bending,there was statistical significance between the two groups compared to the group C p<0.01)Conclusion:ESW therapy combined percutaneous injection of enhanced fibrin glue loaded bone growth factor can promote fracture healing and the method of combination is expected to be a good choice of non-surgical treatment of bone defect.