间歇应用阿仑膦酸钠促进假体的骨整合

Intermittent Application of Alendronate Promote Osteointegration of Prothesis

【目的】在动物模型上,研究间歇应用阿仑膦酸钠能否有效提高骨床骨量、促进假体的骨整合,进而探讨有效应用阿仑膦酸钠促进假体生物学固定的方法和机制,最终为临床间歇应用阿仑膦酸钠促进假体骨整合的理论提供实验证据。【方法】将30只5月龄SD大鼠按随机数表分为3组(SHAM,OVX,ALO组),每组10只。OVX,ALO组雌性SD大鼠切除卵巢建立骨质疏松模型(测量腰椎骨密度降低>20%者),SHAM组行假手术。在各组大鼠的胫骨平台处垂直植入羟基磷灰石假体,ALO组大鼠间歇给予阿仑膦酸钠(7mg/kg·w)12周,处死前皮下注射盐酸四环素进行荧光染色,取带植入体的胫骨制备成薄片,使用骨密度和骨组织计量学方法,观察假体周围的骨量并测量假体的骨结合率。通过对比分析,研究间歇应用阿仑膦酸钠对OP骨床中多孔羟基磷灰石假体骨整合的影响。【结果】间歇应用阿仑膦酸钠处理后ALO组大鼠平均BMD从(0.081±0.009)g/cm2提升为(0.116±0.008)g/cm2,给药前后BMD改变有显著差异(P<0.05);同时阿仑膦酸钠亦显著增加了假体周围骨量,提高假体与主体骨界面骨结合率约40%,较OVX状态骨整合比率提高近二倍,且差异有统计学意义(P<0.05)。【结论】间歇应用阿仑膦酸钠可持续有效的提高松质骨量,同时促进多孔羟基磷灰石假体与骨质疏松骨床界面的骨整合。

[Objective] Based on experimental animal model, this experiment studied the effects of intermittent application of Alendronate on bone mass and osteointegration, furtherly investigating effective fixation ways and mechanism and finally providing experimental evidence for the theory. [ Methods ] Thirty female SD rats, five-months-aged, were randomly divided into three groups （SHAM,OVX,ALO group）, each with ten rats. Rats in OVX and ALO groups underwent ovariectomy to establish osteoporosis model and rats in SHAM group received sham operation. The loss of bone mineral density beyond 20% confirms osteoporosis. Then porous hydroxyapatite prosthesis were inserted into the tibial platform of the left tibia in each group, followed by administration of alendronate （7 mg/kg/w）for twelve weeks in ALO group.＂ which before dead. After dying, the bone mass and osteointegration ratio （O IS） were measured by BMD measurement and the advanced bone histomorphometry. [Results] Intermittent application of alendronate （7 mg/kg/w） could level up BMD value from （0.081 ± 0.009） g/cm^2 to （0.116 ± 0.008） g/cm^2, showing significant difference （P 〈 0.05）; Meanwhile, significantly increase bone mass and improve prosthetic bone attachment and osteointegrated implants surface （OIS） by 40% （P 〈 0.05）, which is two times of that of OVX, showing statistical differenee（P 〈 0.05）. [ Conclusion ] Intermittent application of alendronate （7 mg/kg/w） could sustainably and effectively increase bone mass and promote bony integration of porous Hydroxyapatite prosthesis in osteoporosiscondition.