Therapieeffekte von Testosteron auf die Heilung von Knochendefekten

Zusammenfassung

Studienziel: Androgene wirken proliferativ auf Osteoblasten und beschleunigen die Frakturheilung durch systemische und lokale Stimulation des Knochenwachstums. Ziel der vorliegenden Studie war die Untersuchung, ob die systemische Stimulation der Knochendefektheilung durch Androgene zu einer beschleunigten Defektheilung führt. Methode: 30 Sprague-Dawley-Ratten wurden Trepanationsdefekte mit einem Durchmesser von 1,5 mm in der Femurdiaphyse gesetzt. 10 Tiere wurden als Kontrollgruppe nicht behandelt und je 10 Tiere erhielten 2 Tage vor der Operation entweder 1 oder 10 mg Dihydrotestosteron intramuskulär injiziert. Nach 14 Tagen wurden die Präparate entnommen und makroskopisch, histologisch und histomorphometrisch untersucht. Ergebnisse: Alle Tiere wurden in die Untersuchung aufgenommen und konnten ausgewertet werden. Klinisch zeigten sich keine Komplikationen. Die makroskopische und histologische Untersuchung zeigte keine signifikanten Unterschiede. Alle Defekte waren mit trabekulärem Knochen in direktem Kontakt zum umgebenden Knochen gefüllt. Histomorphometrisch ergab sich ein signifikant geringerer Knochenanteil an der Defektfläche in der Kontrollgruppe als in den beiden Therapiegruppen, die beiden Therapiegruppen unterschieden sich nicht signifikant voneinander. Schlussfolgerung: Die Stimulation der Knochendefektheilung mit Dihydrotestosteron führt zu einem signifikant höheren Knochenanteil im Knochendefekt. In der klinischen Anwendung können Androgene eine Möglichkeit darstellen, gerade bei älteren Patienten die Knochenheilung zu verbessern. Außerdem können sie die Rehabilitation der Patienten durch die Effekte von DHT auf die Muskulatur beschleunigen.

Abstract

Aim: Androgens have proliferative effects on osteoblasts and increase fracture healing by systemic and local stimulation of bone formation. The aim of the present study was to evaluate if the systemic stimulation by androgens leads to increased bone-defect healing. Methods: 1.5-mm trepanation defects were created in the femoral diaphysis of 30 Sprague-Dawley rats. 10 animals were used as untreated controls and 10 animals per group were treated by intramuscular injection of 1 or 10 mg dihydrotestosterone two days prior to surgery. After 14 days the samples were explanted and examined by macroscopy, histology and histomorphometry. Results: All animals were included into the study and were analysed. Clinical observation showed no complications. Macroscopic examination and histology showed no significant differences. All defects were filled with trabecular bone in direct contact to the surrounding bone. Histomorphometry showed a significantly decreased bone content in the controls in comparison to both therapy groups, while the therapy groups showed no significant differences between each other. Conclusion: The stimulation of healing of bone defects with androgens leads to a significantly higher bone content inside the defects. In clinical application, androgens may be a possibility to increase bone formation, especially in elderly patients. Furthermore, it may be possible to shorten postoperative rehabilitation because of the effects of androgens on muscles.

Osteogenese - Knochendefekt - Androgene - DHT - Osteoblast

osteogenesis - bone defect - androgen - DHT - osteoblast

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