骨形态发生蛋白结合微骨折术修复软骨缺损的研究

The Effect of Bone Morphogenetic Protein(BMP) Combined with Microfracture on Repair of Articular Cartilage Defect

目的探讨骨形态发生蛋白(BMP-2)结合微骨折对关节软骨缺损的修复作用。方法选择健康成年新西兰大白兔16只,随机分为实验组和对照组,每组8只(16膝),均造成股骨髁间窝3.5mm全层软骨缺损并在缺损区造成微骨折。实验组软骨缺损区注入20μg BMP-2和0.1m l纤维蛋白胶。对照组软骨缺损区注入0.1 ml纤维蛋白胶。术后8、12周处死动物取标本每次每组4只(8膝),大体观察膝关节活动度及修复组织与周边组织的结合情况,苏木素-伊红染色和甲苯胺蓝染色观察修复组织的形态。根据Wakitani评分测定各组不同时间点标本光镜组织学评分。结果术后8、12周大体观察与组织学观察结果,实验组关节软骨缺损的再生修复均明显优于对照组,差异具有统计学意义(P<0.05)。结论骨形态发生蛋白对软骨再生具有明显的促进作用。

Objective To study the effect of Bone Morphogenetic Protein （BMP） combined with microfracture on repair of articular cartilage defect. Methods 16 New Zealand white rabbits （32 knees） were divided into A and B groups randomly. The 3.5mm in diameter of full- thickness articular cartilage defect and microfracture was made on femoral intercondylar fossa in all rabbits. Group A （8 rabbits, 16 knees） ： The cartilage defect was covered with 20ug BMP and 0. lml fibrin glue. Group B （8 rabbits, 16 knees） ： The cartilage defect was covered with the same dosage of fibrin glue. The rabbits were killed in 8, 12 weeks postoperatively, and the areas of cartilage defect were examined grossly, microscopically and histological scored. Results The cartilage regeneration in Group A was significantly superior to that in Group B （P 〈0. 05）. Conclusion BMP plays an effective role in articular cartilage regeneration.