骨形态形成蛋白复合纤维蛋白载体修复全厚关节软骨缺损的实验研究

The Repair of Osteochondral Defects in Rabbits Using a Composite of Bone Morphogenetic Protein and Fibrin Sealant

目的 :用骨形态形成蛋白 (BMP)复合纤维蛋白载体修复创伤性全厚关节软骨缺损。方法 :6 0只新西兰家兔 ,体重 2 .5～ 3kg ,雌雄不限 ,随机分为 5组。每侧股骨髌髁关节面低速电钻钻一直径为 4mm全厚关节软骨缺损。一侧缺损填充BMP/FS ,对照侧缺损填充单纯FS、单纯BMP和空白组 ,膝关节不做固定 ,允许笼中自由活动。术后 2、4、8、12周空气栓塞分批处死动物 ,大体观 ,组织学切片HE染色 ,S — 10 0蛋白免疫组化染色和透射电镜观察实验结果。结果 :术后 4周 ,BMP/FS填充的部分关节软骨缺损由类透明软骨修复 ;术后 8周 ,实验组缺损大部分由类透明软骨修复 ,而对照组则由纤维软骨或纤维组织修复 ;术后 12周 ,实验组修复组织主要是透明软骨或类透明软骨 ,修复面较平整光滑 ,与周围组织愈合良好。但部分修复软骨面变薄、纤维化。结论 :BMP/FS复合物促进了关节软骨的早期修复 ,并且最终的修复组织更接近正常的关节软骨 ,但术后

Objective:To evaluate the ability of a composite of bone morphogenetic protein and fibrin sealant(BMP/FS) to hasten the repair of full-thickness articular cartilage defects.Methods:4mm diameter,full-thickness articular cartilage defects in 60 rabbits were created in the patellar groove of the femur.The experimental defects were filled with BMP/FS,the control defects were respectively BMP alone,FS alone and empty.The healing of the defects was assessed by gross examination,light microscopy,transmission electron microscopy at various intervals from 2 weeks to 12 weeks.Results:The results showed that in BMP/FS group,newly bone and cartilage were seen at 2 weeks.At 4 weeks,the some reparative tissue more resembled hyaline cartilage.At 12 weeks,most defects were repaired through hyaline-like cartilage or hyaline cartilage.But then the repair cartilage thining,the fibrillation and the fissures in the surface of the repair cartilage started to be observed in some defects.Conclusion:BMP/FS could hasten the repair of the defects at early stage and the final reparative tissue closely resembled the adjacent articular cartilage,but then 12 weeks postoperatively,the resurfacing artilcular cartilage began to degenerate in some defects.