强化力学结构治疗股骨头坏死的实验研究  

Biostructural augmentation for treatment of femoral head necrosis in sheep by a composite of allogeneic bone scaffold, autologous bone and decalcified bone matrix

作　　者：梅荣成[1] 杨述华[1] 杨操[1] 李宝兴[2] 苏成忠[2] 李进[1] 康悦[2] 马洪强[2] 徐亮[1] 

机构地区：[1]华中科技大学同济医学院附属协和医,武汉430022 [2]中国辐射防护研究院山西省医用组织库

出　　处：《中华创伤骨科杂志》2007年第11期1046-1049,共4页Chinese Journal of Orthopaedic Trauma

基　　金：基金项目：国家自然科学基金资助项目（30170945）

摘　　要：目的探讨髓芯减压术后利用同种异体骨支撑架结合自体骨和脱钙骨基质（DBM）植入治疗股骨头坏死的可行性。方法取大尾羊22只，其中2只作为正常对照组，其余20只建立双侧股骨头坏死模型，4周后随机挑选2只检测股骨头坏死情况，确定造模成功后，将其余18只（36侧）随机分为A、B、C三组，每组6只（12侧），A组单纯行髓芯减压，B组在行髓芯减压后植入自体松质骨和DBM，C组在行髓芯减压后植入同种异体骨支撑架、自体松质骨和DBM。分别于术后5、10和20周对股骨头行影像学检查、生物力学测试和组织学观察。结果影像学检查和组织学观察结果显示C组在髓芯减压区骨缺损修复及成骨方面较B组略高，但差异无统计学意义（P〉0．05）；B、C两组都较同时期的A组明显增强，差异有统计学意义（P〈0．05）。生物力学测试结果表明，术后5、10、20周时C组力学强度较A、B两组明显增高，差异有统计学意义（P〈0．05），在10、20周时C组股骨头生物力学强度和正常股骨头无明显差异。结论应用同种异体骨支撑架结合自体骨和DBM治疗股骨头坏死，能有效加强股骨头的力学结构、促进坏死骨的修复及防止股骨头关节面的塌陷。Objective Toexplore a new method for treatment of femoral head necrosis by implanting a composite of allogeneic bone scaffold, autologous bone and decalcified bone matrix （DBM）. Methods Twenty-two big-tail sheep were used in the experiment. Two sheep served as the control without any treatment. Animal models of femoral head necrosis were established in the rest 20 sheep by ligating the lateral and medial femoral circumflex arteries and injecting pure alcohol into the femoral head. Four weeks postoperatively, after 2 sheep were selected randomly to ensure successful establishment of the models, the other 18 sheep were randomized into 3 groups after core decompression. Group A received no further treatment. Group B received implantation of autologous spongy bone and DBM. Group C received implantation of allogeneic bone scaffold, autologous bone and DBM. Radiographic, histological and biomechanical tests were performed at 5, 10, 20 weeks after implantation. Results Histological and radiographic examinations revealed Groups B and C were significantly superior to Group A in bone forming and defect repairing. The biomechanical test showed that the biomechanical properties of the femoral head in Group C were significantly superior to those in Groups A and B （ P 〈 0. 05 ）, and approached to the normal parameters 10 weeks after implantation. Conclusion Implantation of a composite of allogeneic bone scaffold, autologous bone and DBM can not only speed up the repair of necrotic bone but also restore the biomechanical properties of the femoral head.

关 键 词：股骨头坏死 支架 骨移植 绵羊 

分 类 号：R686[医药卫生—骨科学]