不同空间结构钛合金内植物在兔肱骨近端大结节处骨长入的组织学对比研究

Histological Characteristics of Bone-ingrowth of Proximal Humeral Implant with Different Spatial Structures

目的:建立兔肱骨近端钛合金骨小梁孔隙结构与经典孔隙结构内植物植入模型,并对随时间演变不同内植物中骨长入情况进行组织学对比研究。方法:分别建立肱骨近端骨小梁孔隙结构及经典孔隙结构的钛合金内植物植入模型,选取30只骨骼成熟雄兔随机分为2组,每组各15只;并于组内再次随机分为3组,每组各5只,分别于建模后3、6、12周对肱骨近端内植物植入部分进行取材、切片及甲苯胺蓝染色,观察对比随时间演变不同孔隙结构内植物中骨长入的情况。结果:在分别对各组15个样本进行定性观察后发现随着时间的进展,不同内植物孔隙内的骨质均在不断增长,骨长入面积也在不断扩大。组织学定量分析发现3周与6周时骨小梁孔隙结构内植物骨长入面积百分比均显著大于经典孔隙结构内植物(3周时:25.4%±6.9%vs 19.6%±3.7%,P<0.05;6周时:31.2%±1.7%vs 26.9%±5.3%,P<0.05);而在12周时,两组间的骨长入面积百分比相比差异无统计学意义(41.7%±2.5%,39.0%±4.1%,P>0.05)。而两组内分别进行组内比较时,3周、6周、12周这3个时间点两两比较骨长入面积百分比差异均有统计学意义(P<0.05)。结论:不同孔隙结构内植物在兔肱骨近端的骨长入面积随时间均不断增加,早期(6周内)骨小梁孔隙结构内植物的骨长入速度显著大于经典孔隙结构内植物,但远期(12周)两组不同结构内植物骨长入面积并无统计学差异。

Objective To compare the bone-ingrowth characteristics of proximal humeral implant with different spatial structures in rabbits. Methods Thirty adult New Zealand male rabbits were randomly divided into a trabecular structure group and a classic structure group according to their different spatial structures of the titanium alloy screw inserted into the proximal humerus,each of 15. For both groups,the samples were collected respectively at three,six and twelve weeks after the implantation surgery and made into slices to give toluidine blue staining for histological observation. The bone-ingrowth characteristics of proximal humeral implant over time were recorded and compared. Results Histological study showed that the amount of bone ingrowth into the porose cavity of the screw implant increased with time. Quantitative analysis showed significantly more bone ingrowth in the trabecular structure group compared with the classic structure group at both three(25.4% ± 6.9% vs. 19.6% ± 3.7%,P<0.05) and six weeks(31.2% ± 1.7% vs. 26.9% ± 5.3%,P<0.05) after the implantation surgery. No significant difference was detected between the two groups at twelve weeks after the surgery(41.7% ± 2.5% vs. 39.0% ± 4.1%,P>0.05). Within both groups,the bone ingrowth percentage was of significant differences among the three time points(P<0.05). Conclusion The amount of bone ingrowth into the porose cavity of the implant with different spatial structures increased with time at the proximal humerus of rabbits. In the early stage(within six weeks) after surgery,better bone-ingrowth was detected in the implant with trabecular structures compared with the implant with classic structures. However,no difference was detected between the two implants with different spatial structures in the long term(at the twelve weeks) after the surgery.