异体DBM骨粒复合rhBMP-2及骨水泥材料修复骨缺损的实验研究

The study on the bone defect repaired by the compound material of decalcified bone matrix particles combined with rhBMP-2 and impregnated with bone cement

目的探讨异体脱钙骨基质(DBM)骨粒、骨水泥(BC)及重组人骨形态发生蛋白-2(rhBMP-2)复合材料修复实验性骨缺损的能力。方法复合材料植入兔实验性尺骨骨缺损部位(A组),B组植入纯骨水泥棒材作为对照。不同时间行组织学、印度墨汁动脉血管灌注及材料自然断面扫描电镜观察。结果材料植入第2周表面纤维组织样完整包膜形成,材料外周及两端血管形成密集,并向材料中长入;第4、8、12周新生血管明显增多,且深入至材料中央,新生间充质组织继续大量长入;包绕DBM骨粒的间充质组织部分4周转化为软骨。第8、12周软骨趋于成熟,可见含有造血骨髓的新生骨组织形成,其间可见较多的哈佛氏系统;同时,可见明显DBM骨粒被新生组织爬行吸收现象。第4周原自然裂隙部分已被结构紊乱的胶原纤维束充填。第8至12周,可见大量排列紊乱的矿化骨结构沿多方向长入,新生骨组织附于脱钙骨基质骨粒及骨水泥表面,原自然裂隙几近消失。植入B组材料者除外被纤维膜外余无变化。结论脱钙骨基质骨粒、骨形态发生蛋白、骨水泥复合材料具有良好的骨诱导及骨引导生成作用,是良好的骨缺损修复材料。

Objective To analyze the bone defect repaired by compound material of decalcified bone matrix （DBM） particles combined with rhBMP-2 and impregnated with bone cement （BC）. Methods The compound material was implanted into the ulnar bone defect of rabbits. The methods of histology, intravas- cular injections of India ink and scan electron microscope were used. Results The results showed that the surface of the implantation demonstrates complete fibrous tissues membrane and the mesenchyme tissues grew into the compound material to surround DBM particles along the irregular gaps in the early stage. The mesenchyme, cartilage and bone tissues could be inducted and the DBM particles were absorbed by new tissues gradually. An amount of regenerative blood vessels gathered around the implanted material and the blood vessels could grow into it gradually. It was shown that, an amount of regenerative collagens were formed into the implanted material and the ossification developed from the collagens were seen in some places in early. A large amount of new bone which covered the DBM particles and the bone cement along the irregular gaps were found and the irregular gaps were filled up by the regenerative tissues in later. Conclusions The compound material of DBM particles combined with rhBMP-2 and impregnated with bone cement have good capacity of bone conduction and induction. This compound material can be used effectively to repair segmental bone defects.