骨形态形成蛋白修复大面积关节软骨缺损的实验研究

An Experimental Study on Repair of Large Osteochondral Defect with Bone Morphogenetic Protein (BMP)

将骨形态形成蛋白(BMP)用于大面积关节软骨缺损的修复,探讨应用方法,观察修复效果。在51只成年兔股骨的髌髁关节面上制造5mm×10mm的骨软骨缺损,深3～5mm。缺损内分别填充骨形态形成蛋白和纤维蛋白粘合剂复合物(BMP/FS)、BMP、FS,植入物均用自体游离骨膜覆盖,并设单纯骨膜覆盖缺损组和空白对照组。术后2、4、8、12周对缺损修复情况行大体和组织学观察。结果显示:BMP/FS组,8周时软骨下骨再生已完成,12周表层新生软骨组织结构接近正常,修复效果明显优于其它组。

A new method for repair of large osteochondral defect, 5mm multiply 10mm in size, 3 to 5mm in depth, was performed in the surface of patellar- condylus of each femur of 51 adult New Zealand rabbits. The composites of BMP and fibrin sealant (BMP/FS) was implanted into the defect with BMP alone and FS alone as controls. The implanted substance was covered with free autologous tibial periosteum. The defects covered with periosteum alone or without any implantation was also served as controls. The healing of the defects were surveyed by gross and microscopic examination in the 2nd, 4th, 8th, twelfth week postoperation. The healing result of the defects treated with BMP/FS composite and periosteum implantations showed that subchondral bone regenerated well in the 8th week, and new cartilage tended to give normal appearance in the twelfth week, much better than those of the defects treated with other means. We concluded that the BMP/FS composites covered with periosteum could achieve early repairment of large osteochondral defect.