脱蛋白骨复合牛骨形态发生蛋白(BMP)对前交叉韧带重建术后骨隧道扩大的影响

Effect of Deproteinated Bone-BMP Complex on Bone Tunnel Enlargement after Anterior Cruciate Ligament Reconstruction

目的探讨兔异体脱蛋白松质骨(deproteined bone,DPB)复合骨形态发生蛋白(bone morphogenetic protein,BMP)对前交叉韧带重建术后骨隧道扩大的影响。方法取96只成年新西兰大白兔用自体半腱肌腱进行膝关节前交叉韧带重建,共分4组,DPB+BMP组在股骨隧道内植入DPB-BMP复合体,DPB组和BMP组分别在股骨隧道内植入DPB、BMP,空白对照组的股骨隧道内不植入任何材料。于术后4、8、12、16周时分别处死各组中的6只动物,切取标本,测量股骨隧道的宽度,计算隧道扩大率。结果术后4周时,DPB+BMP组、DPB组、BMP组及空白对照组的骨隧道扩大率分别为(23.52±0.43)%、(34.83±0.52)%、(51.57±0.76)%、(56.90±0.81)%,术后8周为(22.21±0.34)%、(35.35±0.46)%、(60.97±0.63)%、(67.18±0.70)%,术后12周为(21.94±0.37)%、(33.01±0.41)%、(50.56±0.54)%、(54.61±0.55)%,术后16周为(20.96±0.35)%、(32.11±0.50)%、(49.29±0.66)%、(53.31±0.59)%,各时点骨隧道扩大率DPB+BMP组<DPB组<BMP组<空白对照组,差异均有显著性(P<0.05)。结论脱蛋白骨复合BMP能减轻前交叉韧带重建术后的骨隧道扩大程度。

Objective To investigate the effect of deproteinated bone（DPB）-bone morphogenetic protein（BMP） complex on bone tunnel enlargement after anterior cruciate ligament reconstruction in rabbits.Methods A total of 96 adult New Zealand white rabbits were used in this study,and divided into 4 groups.In each group,we reconstructed the anterior cruciate ligaments of the animals using semitendinosus autograft.After the operation,DPB-BMP complex,DPB,or BMP was implanted into the femoral bone tunnel of the rabbits in three of the 4 groups.Another group that received neither DPB nor BMP served as a control.In 4,8,12,or 16 weeks after the implantation（6 rabbits in each group at each time point）,we killed the animals to obtain the specimens of the femoral bone tunnel.Then the width of the tunnel was measured,and the percentage of its enlargement was calculated.Results In the DPB＋BMP,DPB,BMP,and control groups,the bone tunnel was enlarged by（23.52±0.43）%,（34.83±0.52）%,（51.57±0.76）%,and（56.90±0.81）% in 4 weeks,（22.21±0 .34）%,（35.35±0.46）%,（60.97±0.63）%,and（67.18±0.70）% in 8 weeks,（21.94±0.37）%,（33.01±0.41）%,（50.56±0.54）%,and（54.61±0.55）% in 12 weeks,and（20.96±0.35）%,（32.11±0.50）%,（49.29±0.66）%,and（53.31±0.59）% in 16 weeks,respectively.The rates of bone tunnel enlargement in the DPB＋BMP group was the lowest at each time point（DPB＋BMP group 〈 DPB group 〈 BMP group 〈 control, P 〈0. 05）. Conclusion DPB-BMP complex can lessen bone tunnel enlargement after anterior cruciate ligament reconstruction in rabbits.