透明质酸钠复合重组人骨形态发生蛋白2凝胶对自体半腱肌重建兔前交叉韧带腱-骨愈合的生物力学分析  

Biomechanical analysis of sodium hyaluronate combined with recombinant human bone morphogenetic protein-2 on tendon-bone healing in anterior cruciate ligament reconstruction using semitendinosus tendon autograft in rabbits

作　　者：郝清海[1] 李汉秀[2] 初涛[1] 魏昌海[1] 赵杰[1] 

机构地区：[1]潍坊医学院,山东省潍坊市261042 [2]潍坊医学院附属潍坊市人民医院,山东省潍坊市261041

出　　处：《中国组织工程研究与临床康复》2008年第49期9669-9672,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:在前交叉韧带重建的早期,腱-骨连接处是整个移植物-骨隧道复合体的薄弱环节,所以腱-骨愈合的情况是关系韧带移植重建成败的关键。目的:观察透明质酸钠复合重组人骨形态发生蛋白2凝胶对自体半腱肌重建兔前交叉韧带后腱-骨愈合的影响。设计、时间及地点:随机对照动物实验,于2007-09/2008-06在潍坊医学院动物实验中心实验室完成。材料:将重组人骨形态发生蛋白2和透明质酸钠混合制成混悬凝胶注射剂。48只兔随机分成2组,每组24只48膝。方法:实验组随机选取一侧于胫骨隧道入口处注入重组人骨形态发生蛋白2与透明质酸钠凝胶(透明质酸钠-重组人骨形态发生蛋白2亚组),另一侧仅做重建后骨道不予处理(未处理亚组);对照组随机选取一侧于胫骨骨道入口处仅注入重组人骨形态发生蛋白2(重组人骨形态发生蛋白2亚组),另一侧仅注入透明质酸钠(透明质酸钠亚组)。主要观察指标:术后2,4,8,12周大体观察肌腱移植物生长情况及在胫骨隧道内的愈合情况,生物力学拉伸试验测定其生物力学的性能。结果:透明质酸钠-重组人骨形态发生蛋白2亚组在术后2周隧道内见稀疏软骨样组织,4～8周时隧道内见沿骨隧道排列的软骨样组织,双股肌腱之间形成稳定组织连接。l2周时出现部分骨样组织包裹肌腱。其他亚组术后2周时隧道内仅为瘢痕组织,到术后12周隧道内肌腱与骨道壁之间仍充满瘢痕组织,未见稳定组织连接形成。4,8和12周透明质酸钠-重组人骨形态发生蛋白2亚组和重组人骨形态发生蛋白2亚组肌腱移植物部分断裂和完全断裂平均载荷高于未处理亚组与透明质酸钠亚组(P<0.05),同时,透明质酸钠-重组人骨形态发生蛋白2亚组高于重组人骨形态发生蛋白2亚组(P<0.05)。结论:注入透明质酸钠-重组人骨形态发生蛋白2的肌腱移植物有良好的生物力学特性,能促进肌腱移�BACKGROUND： The junction of tendon-bone is a weak link in the complex of the anterior cruciate ligament reconstruction, which is the key point in deciding success or failure of the reconstruction. OBJECTIVE： To observe the effect of sodium hyaluronate combined with recombinant human bone morphogenetic protein-2 （rhBMP-2） on tendon-bone healing in anterior cruciate ligament reconstruction using semitendinosus tendon autograft in rabbits. DESIGN, TIME AND SETTING： The randomized controlled experiment with animals was performed at the Laboratory of Animal Experiment Center of Weifang Medical College from September 2007 to June 2008. MATERIALS： The suspended jel injection was prepared by combined rhBMP-2 with sodium hyaluronate. A total of 48 New Zealand rabbits were randomly divided into 2 groups, with 24 animals in each group. METHODS： In the experimental group, the prepared jel injection was injected into the tibial tunnel （SH-rhBMP-2 group）; the other side of tibial tunnel received no other treatment （untreated group）. In the control group, one side of tibial tunnel was injected with rhBMP-2 （rhBMP-2 group）, the other side received sodium hyaluronate （sodium hyaluronate group）. MAIN OUTCOME MEASURES： The gross morphology change of the bundle of tendon graft, as well as the biomechanical property was measured at weeks 2, 4, 8, 12 after operation. RESULTS： In the SH-rhBMP-2 group, sparse chondroid tissue could be found at the 2 weeks of operation, which arranged orderly along the tihial tunnel from 4 to 8 weeks, tendon adhered to adjacent tissue stably, and bony tissue was appeared at the 12 weeks. Only cicatricia[ tissue could be found in other groups at 2 weeks of operation, which remained till 12 weeks, without stable conjunction tissues appeared. The average load of partial/complete rupture of the tendon graft in the SH-rhBMP-2 and rhBMP-2 groups were higher than that of the untreated and sodium hyaluronate groups （P 〈 0.05）, meanwhile, SH-rhBMP-2 group was higher than rh

关 键 词：透明质酸钠 载体 骨形态发生蛋白 前交叉韧带重建术 腱-骨愈合 

分 类 号：R318[医药卫生—生物医学工程]