两种生物材料对前交叉韧带重建术后腱-骨界面愈合影响的研究  

Study on the Effect of Two Types of Bioactive Scaffold Used for Grafted Tendon – Bone Tunnel Healing after Anterior Cruciate Ligament Reconstruction

作　　者：张明军[1] 刘艳[2] 潘玮敏[1] 

机构地区：[1]西安体育学院健康科学系,西安710068 [2]中国农业大学体育与艺术部,北京100193

出　　处：《西安体育学院学报》2014年第3期338-343,共6页Journal of Xi'an Physical Education University

基　　金：国家体育总局体育科研项目(10B019)

摘　　要：目的对两种不同生物材料,纤维蛋白胶复合骨形态发生蛋白(FG-BMP)及重组合异种骨(RBX)对腱-骨界面愈合的效果进行比较评估。方法 51只新西兰大白兔,随机分为3组,行双侧前交叉韧带重建术,FG-BMP组腱-骨界面推注FG-BMP生物材料,RBX组则应用RBX生物材料,对照组则不施加任何材料。术后2、6、12周取材,行影像学检查、组织学分析及生物力学测试。结果 FG-BMP及RBX均能促进腱-骨间骨的生长。术后6周及12周,两组标本腱-骨间骨矿密度值(bone mineral dentisty,BMD)均明显高于对照组(P<0.05),其中术后6周时及术后12周,RBX组的BMD值均高于FG-BMP组;组织学结果显示,至术后12周,RBX组腱-骨界面显示移植肌腱周围被新生骨组织包绕,并且新生骨组织趋向移植肌腱方向生长,镜下新生骨组织数量明显大于FG-BMP组。生物力学测试结果显示,术后6周,应用注射型生物材料治疗的两组最大牵拉力都显著高于对照组,其中RBX组牵拉力最大(P<0.05);术后12周,RBX组明显高于对照组(P<0.05),FG-BMP组尽管高于对照组,但无显著性差异(P>0.05)。结论 FG-BMP组和RBX组均能促进腱-骨界面的愈合,但RBX在加速腱-骨界面愈合方面具有明显优势。Objective Fibrin glue（ FG） combined with bone morphogenetic protein（ BMP） and recombined bone xenograft（ RBX）,were compared to evaluate their effect on the tendon – bone interface healing. Methods 51 New Zealand white rabbits underwent bilateral anterior cruciate ligament（ ACL） reconstruction. In the experimental group,FG-BMP was injected into the interface and RBX was fixed to the both ends of grafted tendon. In control group,there were no biomaterials treatment between grafted tendon and bone tunnel. At 2,6 and 12 weeks,animal were sacrificed and the bone-graft-bone complexes were used to do the imaging,histology,and biomechanical testing. Results FG-BMP and RBC both enhanced the tendon-to-bone interface healing. At 6 and 12 weeks,the values of bone mineral density in RBX group were higher than those in FG-BMP group. The interface of FG-BMP developed new cartilage but the new bone was thinner whereas the interface of RBX had large areas of chondrocyte-like cells,bone formation. The ultimate load of RBX group was highest among three groups at 6 and 12 weeks. Conclusion FG-BMP and RBX can promote the tendon – bone interface healing, but RBX has an advantage on accelerating tendon – bone interface healing.

关 键 词：前交叉韧带重建 骨形态发生蛋白 纤维蛋白溶胶 重组合异种骨 腱-骨界面愈合 

分 类 号：G804.55[文化科学—运动人体科学]