可塑形复合骨修复骨缺损的实验研究

Experimental Study on Shaped Bone Substitute Made from Allogenic/Heterogenic Bone Powder in Bone Defect Repairing

目的探讨利用同种 /异种骨粉和纤维蛋白组织粘合剂 (FS)及骨形态发生蛋白 (BMP)制成可塑形植骨材料修复骨缺损的可行性。方法成年新西兰兔 35只 ,随机自身对照分为三组 ,行双侧桡骨中段截骨制成骨缺损模型。A组左侧 :同种骨 +FS +BMP ;右侧 :同种骨 +FS。B组左侧 :异种骨 +FS +BMP ;右侧 :异种骨 +FS。C组左侧 :空白对照 ;右侧 :同种骨 +FS。A、B组在术后 4、8、12周各处死 5只 ,C组 5只于 12周时处死 ,以大体观察、X线摄片及组织学评分进行评估。结果A组左侧在 12周时完全修复了兔桡骨节段性骨缺损 ,各项评定指标均优于A组右侧及B组左侧(P <0 .0 5 )。结论同种骨 +FS +BMP复合骨是一种具有优良的塑形能力、良好的骨传导及骨诱导能力、高生物相容性、易于吸收替代的植骨材料。去抗原异种骨是一种良好BMP载体 ,可以和纤维蛋白组织粘合剂混合制成可塑形植骨材料 ,用于治疗骨缺损。

ObjectiveTo explore the possibility of bone defect repairing by a new shaped bone substitute made from allogenic/heterogenic bone powder in rabbit experiment. Methods35 mature New Zealand rabbits were divided randomly into 3 groups, segmental radial defects were performed bilaterally in all rabbits; (1)Group A:15 rabbits,allogenic bone powder+fibrin sealant(FS)+bone morphogenetic protein(BMP) was given on the left side and allogenic bone powder+FS on the right side;(2)Group B:15 rabbits, heterogenic powder+FS+BMP was given on the left side and heterogenic powder+FS on the right side;(3) Group C:5 rabbits, the left side without treatment served as control and allogenic bone powder+FS was given on the right side. 4, 8, 12 weeks after operation,5 rabbits were killed each time in Group A and B respectively; 5 rabbits in Group C were killed at the end of 12th week. Results were assessed by gross observation, radiographic and histological examination. ResultsClinical efficacy of allogenic bone powder+FS+BMP was much faster and better than those of allogenic bone powder+FS and heterogenic+FS+BMP in repairing the bone defects(P< 0.05 ),all segmental radial defects in former were fully recovered 12 weeks after operation. ConclusionsAllogenic bone powder+FS+BMP is a kind of excellently shaped and easily absorbable bone substitute with high ability of bony conduction and induction. There will be a widespread prospect in application of allogenic bone powder+FS+BMP as a new shaped bone substitute in plastic and reconstructive surgery. [