复合骨形态发生蛋白-2的人工骨与带血供组织修复羊大段骨缺损  

Tissue engineered artificial bone with composite of BMP-2 and vascularized tissue in repairing the large segmental bone defect

作　　者：周密[1] 徐建强[1] 张树明[1] 李长庚[1] 张娟 孙锁柱[1] 王长江[1] 王克利[1] 

机构地区：[1]第二炮兵总医院骨科,北京100088 [2]第二炮兵537医院门诊部,陕西宝鸡721000

出　　处：《创伤外科杂志》2012年第2期161-164,共4页Journal of Traumatic Surgery

基　　金：全军"十五"医药卫生科研基金课题(06G018)

摘　　要：目的研究组织工程化人工骨结合不同自体带血供组织(长段自体尺骨或屈指长肌)移植修复大段骨缺损的效果。方法手术造成绵羊桡骨30mm骨缺损,A组植入[聚乳酸-乙醇酸共聚物(PLGA)-磷酸三钙(TCP)-骨形态发生蛋白-2(BMP-2)]人工骨及带血运的长段尺骨,B组植入PLGA-TCP-BMP-2人工骨及带血运的屈指长肌肌腹,C组仅植入PLGA-TCP-BMP-2人工骨,D组不植入任何材料。4组均以钢板固定桡骨缺损区。术后24周行手术部位X线摄片,24周处死动物行组织学检查。结果术后24周时,X线检查示A、B组桡骨缺损处完全成骨修复,皮质骨与髓腔的轮廓较为清晰;C组亦能完全修复,但新生骨密度及髓腔轮廓清晰度均不如A、B组;D组无有效骨痂形成。组织学检查结果显示,A组新生骨完全修复骨缺损区;B组骨痂为较成熟的板层骨,骨陷窝较多;C组新生板层骨及骨陷窝排列较为紊乱;D组无骨连接表现。A、B、C组均未见人工骨材料残留。结论 PLGA-TCP-BMP-2人工骨结合带血供的长段自体骨或自体肌肉移植能够很好地修复绵羊桡骨30mm的骨缺损。Objective To study the effects of the tissue engineered artificial bone with vascularized ulna or vascularized muscle transplantation in repairing the large segmental defect of sheep＇s radius.Methods 30 mm defects were made in middle segments of sheep＇s radius and ulna.In group A,the composite of BMP-2 and PLGA/tricalcium phosphate with vascularized ulna were implanted into the radial defects.PLGA-TCP-BMP-2 with vascularized long flexor of digits were implanted into the radial defects in group B.PLGA-TCP-BMP-2 artificial bone were implanted into the radial defects in group C.No material was implanted in group D.Plates were used to fix the bone in all groups.Animals were sacrificed 24 weeks after operation to make histological evaluation.Samantha and Lane Sandhu radiological and scoring histological systems were used to evaluate the plains.Results Twenty-four weeks after surgery,X ray revealed that the bone defect of radius was fully repaired 24 weeks after operation with clear contour of cortical bone and medullary cavity in group A and B.While in group C,the contour was not as clear as in group A B.No effective callus were found in group D.Evaluation of the morphologic features of the regenerating bone showed that active osteogenesis occurred at the site of bone defect and complete bony union was confirmed in animals of group A.In group B,matured callus were composed by new lamellar bone and lacuna.However,the lamellar bone was rather slim.In group C,new lamellar bone and lacuna were found in deranged alignment.In group D,deranged collagenous fibrous tissue,instead of osseointegration was found at the site of bone defect.Within the porous structure in animals of group A,B,and C,no residual artificial materials or muscle fibers were observed.Conclusion The artificial bone with composite of BMP-2 and PLGA/tricalcium phosphate with vascularized ulna or vascularized muscle could repair large segmental defect of sheep＇s radius satisfactorily.

关 键 词：桡骨 骨缺损 人工骨 组织修复 

分 类 号：R683.41[医药卫生—骨科学]