脱蛋白骨复合骨形态发生蛋白对前交叉韧带重建术后腱-骨愈合的影响  

The effect of deproteinated bone-bone morphogenetic protein complex on tendon-bone healing after anterior cruciate ligament reconstruction in rabbits

作　　者：翟文亮[1] 练克俭[1] 宋光虎[1] 

机构地区：[1]解放军第一七五医院全军创伤骨科中心,厦门大学附属东南医院骨科,福建省漳州市363000

出　　处：《中华创伤骨科杂志》2008年第1期72-75,共4页Chinese Journal of Orthopaedic Trauma

基　　金：福建省自然科学基金（X0650099）

摘　　要：目的探讨兔异体脱蛋白松质骨（DPB）复合骨形态发生蛋白（BMP）对前交叉韧带（ACL）重建术后腱-骨愈合的影响。方法取96只成年新西兰大白兔，分为四组，每组24只：DPB＋BMP组、DPB组、BMP组及空白对照组，分别用自体半腱肌腱进行膝关节ACL重建，DPB＋BMP组在股骨隧道内植入DPB-BMP复合体，DPB组和BMP组分别在股骨隧道内植入DPB、BMP，空白对照组的骨隧道内不植入其他材料。于术后2、4、6、8周时分别处死各组中的6只动物，切取骨隧道内标本，通过大体观察及组织学观察分析腱-骨愈合进程。结果术后2周时BMP＋DBP组的骨隧道内新骨生成活跃，肌腱周围出现较多纤维软骨组织；4周时骨隧道内出现钙化的纤维软骨，肌腱末端与钙化软骨融合为一体，并见Sharpey’s纤维形成；6周时隧道内出现了更多的钙化软骨，肌腱与骨的结合区出现潮线，具有正常ACL止点的结构特点；8周时肌腱与骨的连接更加成熟，钙化软骨增多。其他三组的腱-骨愈合过程均迟于DPB＋BMP组。结论DPB复合BMP能促进ACL重建术后的腱-骨愈合。Objective To investigate the effect of deproteinated bone-bone morphogenetic protein （DPB-BMP） complex on tendon-bone healing after anterior cruciate ligament （ACL） reconstruction in rabbits. Methods Ninety-six skeletally mature New Zealand white rabbits were divided into 4 groups. Into the femoral bone tunnels, the DPB-BMP complex plus semitendinosus autograft were implanted in group 1, DPB plus semitendinosus autograft in group 2, BMP plus semitendinosus autograft in group 3, and only semitendinosus autograft in group 4. Next, the rabbits were killed respectively 2, 4, 6 and 8 weeks after implantation to obtain specimens. Groups 2, 3 and 4 served as controls. Gross observation and histological observation were performed to analyze the tendon-bone healing after ACL reconstruction. Results In group 1, new bone grew actively and there was some fibrous cartilage around the implanted tendon 2 weeks after ACL reconstruction. At 4 weeks, calcified fibrous cartilage appeared, the end of implanted tendon consolidated with the calcified fibrous cartilage, and Sharpey＇ s fiber formed in the bone tunnel. At 6 weeks, more calcified fibrous cartilage formed in the bone tunnel and the tide mark appeared in the area of tendon-bone junction, with the histological structure like the normal ACL insertion. At 8 weeks, the junction of tendon and bone became more mature, and more calcified fibrous cartilage was observed. The process of tendon-bone healing in control groups was significantly slower than that in group 1. Conclusion DPB-BMP complex can accelerate tendon-bone healing after ACL reconstruction in rabbits.

关 键 词：膝关节 前交叉韧带 脱蛋白骨 骨形态发生蛋白 兔 

分 类 号：R687[医药卫生—骨科学]