异体DBM复合rhBM P-2修复兔桡骨缺损的实验研究

A Experimental Study of the Efficacy of a Demineralized Bone Matrix Allograft/bBMP Composite Graft in Healing of Rabbit Segmental Radial Defect in Rabbits

目的探讨异体脱钙骨基质(dem inera lized bone m atrix,DBM)复合重组人骨形态发生蛋白2(reconstruc-tion hum n bone m orpho logy prote in-2,rhBM P-2)修复节段性骨缺损的能力。方法48只新西兰大白兔采用桡骨15mm节段性骨缺损模型,随机分为3组,A组植入异体DBM与rhBM P-2复合材料,B组植入异体DBM,C组为空白对照组。术后4周、8周、12周、16周,进行放射学和组织学检查。结果A组:术后4周宿主结缔组织长入植骨材料内的骨小梁间,并有岛状新生软骨、骨组织形成;术后8周,新生软骨及骨形成并融合成片;术后12周,新骨改建成熟,但仍能见到植骨材料;术后16周,管状骨结构形成,髓腔再通。B组:术后4周,植骨材料周围有软骨形成;术后8周,大量软骨形成;术后12周,大片状骨形成;术后16周,有髓腔形成。C组:各时间点仅见有纤维结缔组织,只在两端有新骨形成。X片示A组成骨量大,新骨改建、成熟迅速,术后16周全部达骨性愈合。B组成骨量少,仅2例达骨性愈合。C组未见骨性愈合。结论异体DBM复合rhBM P-2材料通过骨诱导和骨传导两种方式修复骨缺损,是一种较理想、具有高效成骨活性的植骨材料。

Objective To evaluate the efficacy of a demineralized bone matrix allograft/rhBMP-2 composite graft in healing of segmental defect of a radium. Methods 48 rabbits were underwent unilateral radial osteotomies with creation of a 1. 5 centimeter defect. They were divided into three groups A,B,C randomly,the defects in group A were received demineralized bone matrix alllograft/rhBMP-2（4 mg） composite graft, that in group B were received demineralized bone matrix allograft, thai in group C were kept untreated as acontrol. Subjects were underwent monthly radiographs and were killed at four, eight, twelve ,and sixteen weeks. Regenerate bone was studied by histology. Results All sixteen DBM＋rhBMP-2 radii and oniy two of sixteen of DBM radii were progressed to radiographic union, compared. Histology revealed that microscopic evidence of normal bone healing in DBM＋rhBMP-2 radii, whereas most DBM radii demonstrated nonunions, Conclusion The DBM＋rhBMP-2 composite implants is more effective in healing of critical-sized segmental defects than DBM alone in this rabbit model, DBM ＋rhBMP-2 composite graft is a safe and effective bone graft substitute.