富血小板血浆凝胶联合髓芯减压修复兔股骨头无菌性坏死

Platelet rich plasma gel combined with core decompression for repair of aseptic necrosis of the femoral head in a rabbit

背景:近年来的研究表明,富血小板血浆有较强的成骨能力且在骨科及口腔科领域已得到广泛应用,而其在股骨头坏死方面的实验未见报道。目的:观察富血小板血浆凝胶联合髓芯减压修复股骨头无菌性坏死模型兔的效果。方法:取新西兰大白兔25只,在不造成髋关节脱位的基础上,用液氮冷冻兔双侧股骨头建立无菌性坏死模型,造模后2周,随机分组:模型组9只不做任何治疗,髓芯减压组8只行髓芯减压治疗,联合组8只采用富血小板血浆凝胶联合髓芯减压治疗,造模后第8周采集股骨头标本组织切片行MRI检查及苏木精-伊红染色。结果与结论:①MRI检查:模型组表现为股骨头脂肪高信号中出现不同形态的低信号区,呈环形、带状和灶状;髓芯减压组减压缺损区无明显成骨改变,缺损腔无明显缩小,以长T1、T2信号为主;联合组缺损腔消失,被短T1、T2的大量新生骨所充填。②苏木精-伊红染色:模型组关节软骨缺损与修复同时存在,呈现骨性关节炎样改变;髓芯减压组骨小梁空骨陷窝,骨髓内造血细胞和脂肪细胞坏死;联合组骨小梁空骨陷窝,骨髓散在灶状坏死。表明富血小板血浆凝胶联合髓芯减压治疗股骨头坏死模型兔的效果优于单纯髓芯减压治疗。

BACKGROUND：Recent studies have shown that platelet rich plasma has strong osteogenic ability and it has been widely used in the field of department of orthopedics and department of stomatology, but experimental study on avascular necrosis of the femoral head has been not reported. OBJECTIVE：To observe the effect of platelet rich plasma gel combined with marrow core decompression in the repair of aseptic necrosis of rabbit femoral head. METHODS：A total of 25 New Zealand white rabbits were obtained. Without dislocation of the hip joint, aseptic necrosis model was established by using liquid nitrogen cryotherapy on bilateral femoral head of rabbits. At 2 weeks after model establishment, rabbit models were randomly assigned. Model group with nine rabbits did not receive any treatment. Core decompression group with eight rabbits underwent core decompression treatment. Combination group with eight rabbits underwent core decompression combined with platelet rich plasma gel treatment. At 8 weeks after model induction, tissue sections of femoral head specimens were col ected and subjected to MRI and hematoxylin-eosin staining. RESULTS AND CONCLUSION：（1） MRI examination：The model group showed low signal area of different forms in femoral head fat high signal, exhibited annular, ribbon and focal shapes. No evident changes in osteogenesis, no apparent minification of the defect cavity were detected at defect site in the core decompression group, showing long T1 and T2 signals. Defect cavity disappeared, and new bone of short T1 and T2 signals fil ed in the＆amp;nbsp;combination group. （2） Hematoxylin-eosin staining：Articular cartilage defect and repair existed in the model group, showing osteoarthritis-like changes. Empty bone lacuna of bone trabecula, hematopoietic celland adipocyte necrosis in bone marrow were detected in the core decompression group. Empty bone lacuna of bone trabecula, focal necrosis scattered in bone marrow were visible in the combination group. Results suggested that the outcomes of platelet rich plasma gel combined with core decompression were better than core decompression alone in treatment of rabbit models of femoral head necrosis.