自体骨膜、肌腱包裹nHA/PA66复合材料替代腕舟骨的早期实验研究  

Early experimental study on carpal scaphoid replaced by the composite materials of nano-hydroxyapatite/polyamide 66 wrapped by autologous periosteum,tendon

作　　者：尹世杰[1] 黄伟[1] 阳明明[1] 陈浩[1] 聂茂[1] 

机构地区：[1]重庆医科大学附属第一医院骨科,重庆400016

出　　处：《重庆医科大学学报》2010年第8期1129-1133,共5页Journal of Chongqing Medical University

基　　金：重庆市自然科学基金项目(编号:CSTS;2006BB5032);重庆市卫生局重点课题(编号:06-1-002);国家人事部2007年度留学人员科技活动项目择优资助经费;国家科技支撑计划(编号:2007BAE13B00);国家重点基础研究发展计划(编号:2007CB36102)

摘　　要：目的:初步探讨自体骨膜、肌腱包裹致密型纳米羟基磷灰石/聚酰胺66(nHA/PA66)复合材料形成复合体替代重建腕舟骨的可行性。方法:36只新西兰白兔,随机分为A、B、C3组,每组12只。A组:自体骨膜、肌腱包裹致密型nHA/PA66复合材料植入组;B组:自体肌腱包裹致密型nHA/PA66复合材料植入组;C组:单纯自体肌腱球植入组。完整摘除动物双侧桡侧腕舟骨后,分别将上述3种植入物放置于腕关节桡侧腕舟骨缺损处。于术后3、6、12周,取全腕关节标本行大体观察、放射学及组织学观察,并测量腕高率,进行统计学分析。结果:A组植入物在3周和6周时,nHA/PA66复合材料的表面即可见少量软骨母细胞;12周时,软骨母细胞数量增多,材料周缘形成类软骨组织。12周时,nHA/PA66复合材料与周缘软组织间的纤维愈着较3、6周时更为紧密。在不同时间段,均未见nHA/PA66复合材料碎裂、吸收或降解。B、C组植入物在不同时间段均未见类软骨组织在材料周缘形成,但C组腕关节标本较A、B组经大体观察和X线摄片显示腕关节高度明显丢失,塌陷明显。标本X线腕高率经统计学分析,A、B组无明显减低(P>0.05),C组有非常明显的减低(P<0.01)。结论:自体骨膜、肌腱包裹致密型nHA/PA66复合材料形成的复合体在腕关节腔中,其表面能够化生出类软骨组织,且具有良好的抗压强度,可以用作腕舟骨替代物。Objective：To investigate whether the composite materials of dense nano-hydroxyapatite/polyamide 66（nHA/PA66） wrapped by autologous periosteum and tendon can reconstruct carpal scaphoid. Methods：36 New Zealand white rabbits were randomly divided into three groups, A,B, and C,12 rabbits in each group. Group A：composite material of dense nHA/PA66 wrapped by autologous periosteum and tendon;Group B：composite material of dense nHA/PA66 wrapped by autologous tendon; Group C：autologous tendon ball alone. After bilateral carpal bones were completely removed,the above three materials were respectively implanted to replace radial carpal bone. 3,6,12 weeks aftersurgery,the whole wrist was collected forgross observation, radiological and histological examination,and carpometacarpal index was measured for statistical analysis. Results：In Group A,3 and 6 weeks after surgery,a small amount of chondroblasts were found on the surface of the composite material of nHA/PA66;12 weeks after surgery,chondroblasts increased and hyaline-like cartilage formed around the material. The composite materials of nHA/PA66 were combined more closely with soft tissue around by the fibers at the twelfth week than that at the third or the sixth week. During different time periods,no composite materials of nHA/PA66 were fragmented,absorbed or degraded. In Group B and C,no transparent cartilage was found around the implants during different periods,but the gross observation and radiological examination showed that the cartilage in wrists lost obviously and the wrists collapsed significantly in Group C,as compared with those in Group A and B. The statistical analysis showed carpometacarpal indexes in group A and B were not significantly lower（P0. 05）,while that in group C was significantly lower（P0.01）.Conclusion：That autologous periosteum and tendon wrapping densenHA/PA66 could form composite materials in the wrist joint cavity;hyaline-like cartilage could form on their surface,and the materials were so strong that they could

关 键 词：羟基磷灰石 聚酰胺66 骨膜 舟骨坏死 

分 类 号：R683.41[医药卫生—骨科学]