骨膜剥离加髓腔破坏建立股骨头坏死模型的可行性研究

Study on the development of animal model of femoralhead necrosis with perosteum

目的探讨骨膜剥离加髓腔破坏建立股骨头坏死(ONFH)动物模型的可行性.方法成年杂种狗12只(13～17kg),手术剥离其左侧股骨近端约4cm范围内的全部骨膜及周围组织,并于股骨颈中下1/3处用直径1mm的钻头钻孔,破坏此处髓腔松质骨成分,皮质骨保持完整;右侧做正常对照.采用股动脉数字减影血管造影(DSA)技术检测、比较手术前后股骨头局部的血液循环变化,并分别于术后1、4、8和16周获取股骨头标本,行病理切片检查.结果术后DSA图像显示髋关节局部出现多量新生血管由股骨颈、髓内等处再生进入有坏死改变的股骨头内.四组实验侧股骨头均出现不同程度ONFH表现,第16周股骨头标本示轮廓改变,轻度塌陷外观.结论骨膜剥离加髓腔破坏法能成功建立ONFH模型,可用于ONFH的发生、发展机制及治疗的研究.

Objective： To develop a new kind of animal model mimicking the human-like osteonecrosis of the femoral head （ONFH）. Methods： 12 skeletally matured mongrel dogs （13～17kg） were used in the experiment. After capsulotomy, the ligamentum teres was cut, the proximal 4cm of the periosteum of the proximal femur and all of the other attachments were sharply dissected, and the marrow cavity was destroyed by a 1-mm-diameter drill at almost the baseline of the femoral neck as well. The integrity of cortical bone at this position was maintained. Digital Subtraction Angiography （DSA） was performed to compare the preoperative blood flow surrounding femoral head with the postoperative one. Histological slices were obtained at 1, 4, 8, 16 weeks after operation. Results： All operated femoral heads showed osteonecrosis at different level. On visual inspection, specimen at 16 week had obvious evidence of collapse. DSA images displayed that there were many new blood vessels revascularized around the operated femoral head. Conclusions： This kind of model is helpful to the study of treatment of ONFH in human.