股骨头内支撑器/重组人骨形态发生蛋白/自体松质骨对犬股骨头坏死软骨下骨缺损的修复  

Titanium Cage/autocancellous graft/rhBMP-2 to repair the defect and restore the mechanics of the canine's femoral head

作　　者：康鹏德[1] 王坤正[2] 党小谦[2] 裴福兴[1] 杨静[1] 

机构地区：[1]四川大学华西医院骨科,成都610041 [2]西安交通大学第二医院骨科

出　　处：《中华实验外科杂志》2005年第6期729-731,i004,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探索应用新材料、新方法修复股骨头坏死骨缺损重建股骨头力学性能的新方法。方法活门法(trapdoor)建立犬股骨头骨缺损模型。通过活门A组植入股骨头内支撑器/重组人骨形态发生蛋白(rhBMP)2/自体松质骨;B组植入重组人骨形态发生蛋白(rhBMP)2/自体松质骨;C组植入自体松质骨。通过组织学、影象学、生物力学观察评价对股骨头骨缺损的修复以及重建股骨头力学性能的效果。结果各组均未出现关节脱位、关节间隙正常。A组缺损区修复,无关节软骨塌陷,内支撑器与周围骨组织融合;B组,骨缺损区修复,但骨密度低于周围骨组织;C组,仅缺损区周围少量低密度骨形成。A组组织学无软骨塌陷,内支撑器周围新生骨组织包绕,与周围骨组织融合;B组2例软骨塌陷(1.2mm,1.5mm),活门区软骨色泽近与正常,缺损区由新生骨组织填充;C组,活门区软骨塌陷(1.8～5.2mm),色泽苍白,质软易碎,骨缺损区边缘少量新生骨组织,骨小梁纤细稀疏。A组抗压强度为(289.46±23.05)MPa,B组抗压强度为(128.34±6.23)MPa,C组抗压强度(119.54±64.75)MPa,A明显强于B、C两组,且差异有统计学意义(P<0.05)。结论应用股骨头内支撑器/rhBMP2/自体松质骨修复股骨头软骨下骨缺损可以加快修复速度,并且恢复重建股骨头力学强度,有效的防止股骨头关节软骨的塌陷。Objective To explore a new method using new material and technology to repair the defect and restore the mechanics of the canines's femoral head.Methodes In this experiment,the canines were divided into three groups randomly:Group A,the defects were implanted into Titanium cage/autocancellous graft/rhBMP-2;Group B,implanted into autocancellous/rhBMP-2;Group C,implanted into autocancellous only.Roentgenographic and histological examinations were performed at various time points after implantation.Finally,biomechanical test was carried out.Results No hip joint dislocation occurred.The defects in the groups A and B were repaired completely and titanium cage in the group A were combined with new bone.In group C,however,only had little new bone formed.In the group B,the new bone formations were more and earlier than in the group C.No cartilage collapsed in the group A,but in the group B and group C the cartilages collapsed 1.2- 5.2 mm respectively.Biomechanical properities of the repaired areas in the group A were significantly superior to those in the groups B and C (P< 0.05).Conlusion Titanium cage/autocancellous graft/rhBMP-2 not only can enhance the repairing procedure but also can restore the biomechanical properities of the femoral heads.

关 键 词：股骨头内支撑器 重组人骨形态发生蛋白 自体松质骨 犬 股骨头坏死 软骨下骨缺损 

分 类 号：R687[医药卫生—骨科学]