钙磷骨水泥/复合脱蛋白骨关节移植修复兔股骨远端关节缺损  

Calcium phosphate cement combined with deproteinized osteoarticular allograft for the treatment of rabbit distal femur joint defect

作　　者：陈歌[1] 蒋电明[2] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川省泸州市646000 [2]重庆医科大学第一附属医院骨科,重庆市400016

出　　处：《中国组织工程研究与临床康复》2009年第42期8265-8268,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:研制有生物活性的人工关节是当前的重要课题,而载体+骨诱导因子+生长因子模式人工骨已被证实是理想的人工骨材料。目的:课题组创新性地采用钙磷骨水泥为载体,将其与骨形态发生蛋白及生长因子复合,并观察新型钙磷骨水泥/复合脱蛋白骨关节移植修复兔股骨远端关节缺损模型的成骨及血供重建能力。设计、时间及地点:随机对照动物实验,于2003-01/2006-06在重庆医科大学动物实验室完成。材料:取新鲜新西兰大白兔股骨远端(15mm)制作脱蛋白骨关节,将人重组肿瘤坏死因子α、人重组骨形态发生蛋白2分别与钙磷骨水泥和脱蛋白骨关节复合,冷冻干燥,环氧乙烷消毒备用。方法:手术造成兔股骨远端15mm关节缺损实验模型,将40只新西兰大白兔随机均分成两组:实验组将混合有人重组骨形态发生蛋白2、人重组肿瘤坏死因子α的钙磷骨水泥在异体脱蛋白骨关节表面涂层和髓腔内填塞后,置换一侧股骨远端;对照组进行单纯异体脱蛋白关节股骨远端移植。主要观察指标:植入后4,8,12,16周分别行X射线摄片以及组织学检查,观察骨缺损愈合情况、移植关节端成骨与成软骨情况;并于16周行血管造影,了解局部血供重建情况。结果:实验组在移植后第4周可观察到大量新生血管出现,网织状骨形成。至第12～16周时,复合脱蛋白骨关节完全存活,断端愈合。光镜下各时期的成骨面积实验组均大于对照组。股动脉血管造影示实验组移植部位周围血管数量明显多于对照组。结论:钙磷骨水泥/复合脱蛋白骨关节具有良好的成骨能力,在体内能促进股骨远端关节缺损的血供重建、愈合和替代。BACKGROUND： Research of artificial joint with bioactivity is a hot topic during recent years. Artificial bone made by vector, osteoinductive factor, and growth factor has been proved as an ideal biomaterial. OBJECTIVE： To make calcium phosphate cement （CPC） combining with bone morphogenetic protein and growth factor, and evaluate the osteogenesis and blood-supply reconstruction of CPC/deproteinized osteoarticular allograft for the treatment of rabbit distal femur joint defect. DESIGN, TIME AND SETTING： A randomized controlled animal experiment was performed at Animal Laboratory of Chongqing Medical University from January 2003 to June 2006. MATERIALS： Rabbit distal femur （15 mm） was obtained to make deproteinized osteoarticular allograft. Human recombinant tumor necrosis factor-α and human recombinant bone morphogenetic protein 2 were combined with CPC and deproteinized osteoarticular allograft, respectively. The mixture was then cooled, dried, and sterilized with ethylene oxide. METHODS： A 15-mm distal femur was established joint defect models. A total of 40 New Zealand rabbits were randomly divided into experimental and control groups. In the experimental group, CPC mixed with human recombinant tumor necrosis factor-α and human recombinant bone morphogenetic protein 2 were coated on the surface of deproteinized osteoarticular allograft and filled in pulp cavity, and distal femur was then displaced. In the control group, rabbits were treated with deproteinized osteoarticular allograft alone. MAIN OUTCOME MEASURES： X-ray and histological examinations were performed to observe defected bone healing, osteogenesis, and cartilage formation at the transplanted side at 4, 8, 12, and 16 weeks after transplantation. Angiography was performed to evaluate blood-supply reconstruction in local region after 16 weeks. RESULTS： In the experimental group, a lot of vasoganglion and weave bone were observed at 4 weeks after transplantation. At 12-16 weeks after transplantation, composite deproteinized osteo

关 键 词：骨移植 脱蛋白骨 骨形态发生蛋白 生长因子 

分 类 号：R318[医药卫生—生物医学工程]