聚乳酸-乙醇酸共聚物-磷酸三钙-骨形态发生蛋白2人工骨结合肌肉移植修复骨缺损

Polylactic-co-glycolic acid-tricalcium phosphate-bone morphogenetic protein-2 artificial bone combined with muscle transplantation for repair of bone defects

背景:大段骨缺损修复多以植骨为主,如果能将带血运的组织与人工骨同时植入,理论上更有利于新生组织血运建立及人工骨的爬行替代重建。目的:观察聚乳酸-乙醇酸共聚物-磷酸三钙-骨形态发生蛋白2人工骨结合自体带血供自体肌肉移植修复大段骨缺损的效果。方法:手术造成30mm绵羊大段桡骨缺损,抽签随机分为3组:实验组植入聚乳酸-乙醇酸共聚物-磷酸三钙-骨形态发生蛋白2人工骨及自体带血运的屈指长肌,对照组仅植入聚乳酸-乙醇酸共聚物-磷酸三钙-骨形态发生蛋白2人工骨,空白对照组未植入任何材料。3组均以钢板固定骨缺损区,术后24周进行X射线检测及组织学观察。结果与结论:实验组桡骨缺损处完全成骨修复,皮质骨与髓腔轮廓清晰,骨痂为较成熟板层骨;对照组骨缺损基本完全修复,但新生骨密度及髓腔轮廓清晰度及骨痂成熟度均不如实验组;空白对照组无有效骨痂形成,缺损区被大量纤维组织填充。说明聚乳酸-乙醇酸共聚物-磷酸三钙-骨形态发生蛋白2人工骨结合自体带血供肌肉移植能够很好修复绵羊桡骨30mm的大段骨缺损。

BACKGROUND：Large segmental bone defects are mostly repaired by bone graft.If the tissue with blood life and artificial bone were simultaneously implanted into bone defects,which are theoretically more conducive to the construction of new tissue blood life and reconstruction of artificial bone creeping substitution.OBJECTIVE：To observe the effects of the composite of polylactic-co-glycolic acid-tricalcium phosphate-bone morphogenetic protein-2（PLGA-TCP-BMP-2） artificial bone combined with vascularized muscle transplantation in repairing the large segmental defect.METHODS：A 30 mm defect was made in large segment of sheep＇s radius.The experiment was randomly divided into 3 groups.Experimental group was implanted into PLGA-TCP-BMP-2 artificial bone and vascularized long flexor of digits;control group was only implanted into PLGA-TCP-BMP-2 artificial bone;no material was implanted into blank group.Plates were used to fix the bone in 3 groups,and then underwent X ray detection and histological observation at 24 weeks after operation.RESULTS AND CONCLUSION：Bone defect of radius was fully repaired with clear contour of cortical bone and medullary cavity,callus was mature lamellar bone in experimental group.While in control group,the contour was not as clearly as in experimental group.No effective callus was found and the defect area filled with abundant fibrous tissue in blank group.PLGA-TCP-BMP-2 artificial bone combined with vascularized muscle transplantation can repair large segmental defect of 30 mm sheep＇s radius satisfactorily.