复合骨形态蛋白-2的聚乳酸-乙醇酸共聚物/磷酸三钙人工骨结合带血供组织修复羊大段骨缺损的试验研究

An experimental research of composite of BMP-2 and PLGA/tricalcium phosphate with vascularized ulna or vascularized periosteum in repairing large segmental defect of sheeps' radius

目的研究复合骨形态蛋白-2的聚乳酸-乙醇酸共聚物/磷酸三钙(PLGA-TCP-BMP-2)人工骨结合尺骨骨膜及长段自体骨移植修复大段骨缺损的效果。方法手术造成30 mm绵羊桡骨骨缺损,A组植入人工骨及带血运的长段尺骨,B组植入人工骨及带血运的尺骨骨膜,C组仅植入人工骨,D组不植入任何材料。四组均以钢板固定桡骨缺损区。术后行X线摄片,24周处死行CT及组织学检查,进行系统评价。结果 X线检查示术后放射学评分A组高于其它各组。组织学结果显示,A组新生骨完全修复骨缺损区;B组新生骨与断端皮质骨融合,新生骨痂较为纤细;C组新生板层骨及骨陷窝排列较为紊乱;D组无骨连接表现。A、B、C组均未见人工骨材料残留。A组组织学评分最高,D组最低,差异有显著性。结论PLGA-TCP-BMP-2人工骨结合长段自体骨或带血供尺骨骨膜移植能够很好的修复绵羊桡骨大段骨缺损。

Objective To study the effects of the composite of PLGA-TCP-BMP-2 artificial bone with vascularized ulna or vascularized periosteum in repairing the large segmental defect of sheep＇s radius.Methods Thirty millimeter defects were made in middle segments of sheep＇s radius and ulna.In group A,artificial bone with vascularized ulna were implanted into the radial defects.Artificial bone with vascularized periosteum were implanted into the radial defects in group B.Artificial bone were implanted into the radial defects in group C.No material was implanted in group D.Plates were used to fix the bone.X ray was used to evaluate the repairing effects.Animals were sacrificed 24 weeks after operation to make CT analysis and histological evaluation.Radiological and scoring histological systems were used to evaluate the plains.Results Twenty four weeks after surgery,radiological scoring systems revealed that group A was better than other groups.Evaluation of the morphologic features of the regenerating bone showed that active osteogenesis occurred at the site of bone defect and complete bony union was confirmed in animals of group A.In group B,corporation between new bone and fracture site could be seen.However,the lamellar bone was rather slim.In group C,new lamellar bone and lacuna were found in deranged alignment.In group D,deranged collagenous fibrous tissue,instead of osseointegration was found at the site of bone defect.Within the porous structure in animals of group A,B,and C,no residual artificial materials or muscle fibers were observed.According to histological scoring systems revealed that group A was better than other groups.Scores of group D was lower than other groups.Conclusion The composite of BMP-2 and PLGA/tricalcium phosphate with vascularized ulna or vascularized periosteum could repair large segmental defect of sheeps＇ radius satisfactorily.