四种复合体体内成骨及成软骨后重建月骨缺血性坏死的实验

In vivo osteogenetic and chondrogenetic ability of four kinds of composites in the reconstruction of lunate bone with ischemic necrosis

目的:评价4种复合体在体内成骨、成软骨能力,探索重建月骨治疗月骨缺血性坏死的可行性。方法:按随机数字法将60只日本大耳白兔分为4组:骨膜包绕肌腱松质骨粒与骨形态发生蛋白组(A组),骨膜包绕松质骨粒与骨形态发生蛋白组(B组),骨膜包绕肌腱与骨形态发生蛋白组(C组),骨膜包绕肌腱组(D组)。将4组复合体分别置于兔膝关节髌上囊,术后进行放射学、组织学及电镜检查。结果:A,B组复合体2周即有新生骨出现,8周形成外周为完整骨包壳中心为骨髓细胞的类圆形骨性团块,C组复合体4周有新生骨与软骨形成,8周形成较成熟骨小梁,24周形成骨性团块;D组复合体24周内无骨团块形成。术后A,B,C组与D组复合体CT值进行比较,差异均有显著性意义。结论:A组复合体兼有良好的可塑性和成骨时间早等优点,为重建月骨的首选方法。

AIM:To evaluate osteogenetic and chondrogenetic ability of four kinds of compo sites in vivo and probe into the feasibility of ischemic necrosis of lunate bone treated by reconstructing lunate bone. METHODS:Sixty flap eared Japanese rabbits were equally divided into four grou ps by means of random number table.Periosteum wrapping tendon,grains of cancello us bone and bone morphogenic protein(BMP) were used in group A,periosteum wrappi ng grains of cancellous bone and BMP in group B,periostum wrapping tendon and BM P in group C and only tendon wrapped by periostum in group D.The four composites were implanted into rabbits' suprapatellar bursa respectively.X ray imaging,hi stological and electron microscope(EM) changes at varies intervals after operati on were observed. RESULTS:In group A and B,newly formed bone could be found at 2 weeks.Rounded b ony body with complete bone shell and bone morrow was formed by the implanted co mposite at 8 weeks.In group C newly formed bone and cartilage was found at 4 wee ks.Mature bone trabecula was formed at 8 weeks.Rounded bony body was formed at 2 4 weeks.In group D,the composite didn't form bony body until 24 weeks.In differe nt periods,significant difference in CT value was found among group A,B,C and D. CONCLUSION:The composite of group A has both early ossification and good plast icity,so it can be considered as a preferred strategy to reconstruct lunate bone .