不同剂量阿仑膦酸钠对磨损颗粒诱导假体周围骨溶解的影响

Effects of alendronate of different dose on the periprosthetical osteolysis induced by the wear particles

目的观察不同剂量阿仑膦酸钠对磨损颗粒诱导假体周围骨溶解的影响,确定其合适剂量。方法雄性SD大鼠24只,经膝关节将钛合金假体及混合磨损颗粒植入胫骨近端(双侧),随机分为对照组和实验Ⅰ、Ⅱ、Ⅲ组,每组6只,术后对照组每日空腹生理盐水2ml灌胃;实验Ⅰ、Ⅱ、Ⅲ组每日空腹阿仑膦酸钠灌胃,剂量分别为0.01、0.1、1mg/(kg.d),持续6周。术后12周处死取材,进行组织学观察及组织形态计量学测定。结果对照组和实验Ⅰ组假体柄周围纤维界膜厚,细胞成分多,与纤维界膜连接处新生骨边缘呈虫蚀状,新生骨对假体的支撑作用较差;实验Ⅱ、Ⅲ组假体柄周围纤维界膜较薄,新生骨与假体间可见有直接接触,对假体有良好的支撑作用。假体周围界膜厚度及面积的形态计量学检测并经统计学分析显示:对照组与实验Ⅰ组、实验Ⅱ与Ⅲ组间差异无显著性(P>0.05),对照组和实验Ⅰ组分别与实验Ⅱ组和实验Ⅲ组间差异有显著性(P<0.05)。结论以阿仑膦酸钠预防磨损颗粒诱导的假体周围骨溶解时,最适合剂量为0.1mg/(kg.d)。

Objective To determinated the proper dose of alendronate by observing the effects of alendronate of the different dose on the periprosthetical osteolysis induced by the wear particles. Methods The specially designed implants made of Ti alloy and the mixed wear particles were placed into the proximal part of bilateral tibias of 24 SD rats. Then the rats were divided into the control group（6 rats）, the experimental Ⅰ （6 rats） , Ⅱ （6 rats） and Ⅲ group（6 rats） randomly. In the control group, the saline was perfused into the empty stomach daily for 6 weeks; in the experimental Ⅰ , Ⅱ , Ⅲgroup, and alendronate, 0. 01, 0. 1 and 1 mg/（kg · d）, was perfused into the empty stomach daily for 6 weeks respectively. At 12 weeks postoperatively, these rats were sacrificed with the overdose anesthesia and all of the tibias were harvested. Then the histology and the histomorphometry were carried out. Results The histological analysis showed that there were fibrous membrane and the needy formed bone around the implant in the control group and experimental Ⅰgruup. The fibrous ,nenlbrane was thick with large numbers of cells. The interface between the fibrous membrane and the newly formed bone was eclipsed. The newly formed bone could not support the prosthesis. In the experimental Ⅱ , Ⅲ group, the histological analysis showed that there were fibrous membrane and the newly formed bone around the implant. The fibrous membrane was thin and rare with few cells. It could be seen that the newly formed bone could support the prosthesis. Thickness and area of the fibrous membrane around the implant tested by the histomorphometry showed that the difference was insignificant between the control group and the experimental Ⅰ group, and between the experimental Ⅱ andⅢ group in statistics（P 〉0. 05）. But the difference was significant between the control group, the experimental Ⅰ group and the experimental Ⅱ ,Ⅲ group in statistics respectively（P 〈0. 05）. Conclusions When using Alendronate to prevent the periprosthetical osteolysis induced by the wear particles of the artificial joint, the optimal dose is 0. 1 mg/（kg · d） .