bBMP/胶原/珊瑚复合人工骨修复股骨头骨缺损的实验研究

Experimental Study of bBMP/Collagen/Coral Composited Bone Substitute in Repairing of Bone Defect of Femoral Head

目的 研究用复合人工骨治疗股骨头坏死的效果。方法 建立双侧股骨头内骨缺损模型 ,并分为 4组 :bBMP/胶原 /珊瑚复合人工骨组 (6侧 )、肌骨瓣组 (6侧 )、单纯珊瑚组 (2例 )、对照组 (14例 ) ,为上各组的对侧。对植入后 3周、 16周的股骨头行病理学检查、计量组织学分析及四环素荧火标记。结果 16周后 ,复合人工骨的骨缺损大小、缺损区骨小梁体积、荧光带宽度均与对照组有统计学显著性 ,但 5侧中有 1侧出现继发性骨关节炎。结论 该复合人工骨有较强的传导成骨及诱导成骨作用 ,是修复股骨头骨缺损的良好移植材料 ,但它不能改善缺血坏死股骨头的血供。该股骨头内骨缺损加用 95 %酒精灌注 ,模型近似于股骨头坏死囊性变 。

Objective To evaluate the effectiveness of bBMP/collagen/coral composited bone substitute in treatment of avascular necrosis of the femoral head(ANFH).Methods Animal model of bone defect of canine bilateral femoral heads were established.They were divided into 4 groups:①composited bone substitute group(n=6),②muscle pedicle bone group(n=6),③simple coral group(n=2),④control group:contralateral hip(n=14).Pathological examination was studied at 3 weeks and tetracycline labelling,metrical histological analysis were studied at 16 weeks.Results At 16 weeks,there were statistically significant differences of the size of bone defect,trabecular bone volume and width of tetracycline fluorescent zone between composited bone substitute group and control group.one of 5 cases of bone substitute group developed secondary osteoarthritis.Conclusions The composited bone substitute possesses a superior osteoinductivity and osteoconductivity in repairing of bone defect of femoral head,but it can't improve the revascularization of ANFH.The bone defect model of femoral head is similar to cystic change of ANFH and can be used in the study of treatment of ANFH.