体外冲击波治疗对组织工程化骨修复节段性骨缺损的影响

The effect of extracorporeai shock waves on bone repair at segmental bone defects

目的探讨体外冲击波对组织工程化骨修复节段性骨缺损的影响及其作用机制。方法 18 只健康成年绵羊随机分为实验组与对照组,每组9只。对照组在骨缺损区植入β-磷酸三钙陶瓷与自体间充质干细胞复合体,实验组植入复合体后再适时进行体外冲击波(ESW)治疗。治疗后4,8,12周分批处死动物,行X线摄片、组织学、生物力学和扫描电镜观察。结果术后8周2组动物骨缺损愈合未见明显差异,12 周后实验组动物骨缺损基本愈合,骨痂面积和密度均比对照组明显增高。结论冲击波疗法能促进组织工程化骨的成骨能力,其作用机制在于促进间充质干细胞向成骨细胞分化,加速陶瓷降解,改善血供。

Objective To investigate the effect of extracorporeal shock wave （ESW） treatment on bone repair at segmental bone defects, and to study the underlying mechanism. Methods Bone defects were induced in 18 sheep, which were then randomly divided into two groups： one group implanted tissue-engineering bone in bone defects, another group treated with ESW after implantation of the tissue-engineering bone. The sheep were sacrificed at 4, 8 and 12 weeks after the operation. Radiography, histology, biomechanical testing and scanning electron microscopy were used to observe changes at the defects. Results At the 8th week, there was no observable difference betwee, the two groups. After 12 weeks, all results revealed almost complete repair in the experimental group. The osteotylus area and density were both higher than in the controls. Conclusion ESW was able to enhance osteogencsis around artificial bone, It may promote mesenchymal stem cell differentiation, accelerate the degradation of the ceramic and improve blood supply.