钛合金支撑架植入治疗股骨头缺血性坏死的动物实验研究

Titanium alloy cage implantation for the treatment of the ischemic necrosis of femoral head in dogs

[目的]通过动物模型,观察支撑架置入治疗狗股骨头缺血性坏死的疗效。[方法]本研究设计一种中空多孔圆柱状带螺纹的钛合金支撑架,选用成年杂种狗15只,用液氮冷冻法制造股骨头坏死模型,通过中心减压钻隧道至股骨头坏死区软骨下骨,然后沿隧道拧入支撑架。术后分期处死,取标本观察相关指标。[结果]术后无1例发生股骨头塌陷,X线片显示支撑架位置良好,组织学观察显示术后坏死股骨头得以逐步重建,再生的松质骨小梁能够长入支撑架中并改建、修复、替代股骨头内坏死的骨组织,形成穿越支撑架网孔的网状松质骨结构。[结论]利用多孔中空支撑架给股骨头坏死区软骨下骨板提供支撑,防止股骨头塌陷。多孔网状结构容许松质骨的长入和爬行替代,对治疗狗股骨头坏死有明显疗效。提示钛合金支撑架可用于股骨头坏死的治疗。

[ Objective ] To explore the results of the treatment of the ischemic necrosis of femoral head using titanium alloy cage in animal models. [Method] The ischemic necrosis of femur head was made with the liquid nitrogen in 15 hybrid adult dogs. The titanium alloy cage of threaded central empty cylinder with multi-hole periphery was driven into the full depth of the center decompression canal to the subchondral bone. The dogs were divided into 3 groups, 5 dogs in each groups were sacririced respectively at 3, 6, 12 weeks after operation. Radiograph and histologic examination were used to evaluate the results. [Result] No collapse of femoral head was observed postoperation. The position of the cages was located wall in X-ray films. Under microscope, the cancellous bone of necrotic femoral head rebuilted up gradually. The cancellous bone grew into cage. After 12-week creeping substitution, the cancellous bone filled up the hollow and the peripheral holes of the cages. [ Conclusion] The titanium alloy cage can provide structural support to the subchondral bone and prevent collapse. The cancellous bone grows into the cages through the peripheral holes. The necrotic femoral heads are restoration. The titanium alloy cage could be recommended for the treatment of the ischemic necrosis of femoral head.