深低温保存的节段性部分脱钙异体骨关节移植修复兔骨关节缺损  

Osteoarticular allograft with distal segment partial demineralized for repairing large osteoarticular defect in a rabbit model: radiological and histological results

作　　者：杨强[1,2] 李建民[1] 夏群[2] 李庆波[3] 孙鹏飞[1] 李恩惠[1] 谢飞彬[1] 千建荣[1] 李振峰[1] 

机构地区：[1]山东大学齐鲁医院,山东济南250012 [2]天津市天津医院脊柱科,天津300211 [3]山东大学第二医院骨科,山东济南250033

出　　处：《生物骨科材料与临床研究》2013年第3期11-14,67,共5页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：国家自然科学基金(31000432);中国博士后科学基金项目(2011M500530;2012T50235)

摘　　要：目的研究对深低温冷冻保存的同种异体骨关节在与宿主骨结合部行部分脱钙处理对其与宿主骨愈合的影响。方法从健康新西兰兔截取近端桡骨骨关节2cm,去除软组织及骨髓组织,用生理盐水冲洗干净。实验组行桡骨骨关节远端5mm部分脱钙:4℃下桡骨骨关节远端5mm浸入0.6mol/L HCl中脱钙4h,去离子水反复冲洗;对照组不行脱钙处理。用10%的二甲基亚砜浸泡30 min后,冷冻保存1月后使用。在新西兰大白兔双侧桡骨近端造成2cm骨关节缺损模型,左侧为实验侧,右侧为对照侧,分别移植深低温冷冻并且远端部分脱钙的异体骨关节以及单纯深低温冷冻的异体骨关节。在术后1、2、3个月时做大体标本、X线、ECT以及组织学检查,观察异体骨关节与宿主骨结合部。结果实验组X线和组织学评分在术后1、2、3个月时均高于对照侧,差异具有显著性。ECT显示术后第1个月骨代谢活跃,2、3个月有下降趋势,实验侧部分脱钙段骨代谢高于周围骨及对侧对照侧。结论在深低温保存的同种异体骨关节与宿主骨结合部行部分脱钙有利于异体骨关节与宿主骨的愈合,适合大段骨关节缺损的修复。Objective To investigate the results of osteoarticular allograft with distal segment partial demineralized for repairing large osteoarticular defect in a rabbit model. Methods The osteoarticular allograft about 20mm long was excised by hacksaw from the proximal portion of radius obtained from other 24 rabbits of the same strain. The grafts were procured aseptically and stripped of attached soft tissues, including the periosteum, ligaments and muscles. The marrow was re- moved. The osteoarticular allograft was treated in two methods： （1） The distal end （about 5mm long） of the osteoarticular allograft was demineralized by 0.6 mol/L HC1 at 4 ~C for 4 hours, then the osteoarticular allograft was crypreserved （-80~C） for at least 2 weeks. （2） Not demineralized, merely cryopreserved for at least 2 weeks. Large osteoarticular defects about 2cm in New Zealand whit rabbits＇ radius were created. Then we inserted the frozen osteoarticular allograft with the distal segment partial demineralized into left oteoarticular defects, and frozen osteoarticular allograft into the right. The results was evaluated with plain films, gross specimen, histological examination and bone scintigraphy at 1,2,3 months posto- peratively. Results The scoring outcome of radiological and histological analysis between the experimental and control side at 1,2,3 months postoperatively showed that the process of partial demineralization at the distal segment of the oste- oarticular allograft was significant in enhancing bone incorporation at the sites of graft-host bone junction. ECT scan sho- wed that bone metabolism was more active in the 1 month and became stable in the 2 and 3 months postoperatively. The bone metabolism of distal segment of the osteoarticular allograft of experimental side was more active than that of control side. Conclusion Partial demineralization at the distal segment of osteoarticular allograft can accelerate the incorporation of graft-host junction and reduce the complications, which makes it a suitable ca

关 键 词：异体移植 骨关节 节段性 部分脱钙 核素骨扫描 

分 类 号：R687.3[医药卫生—骨科学]