PMMA骨水泥与磷酸钙骨水泥诱导成膜及其对成骨活性的差异

Osteogenic activity of PMMA bone cement-induced membrane with calcium phosphate bone cement-induced membrane

目的比较PMMA骨水泥与磷酸钙骨水泥诱导周围形成膜的结构和成骨活性的差异。方法 32只健康成年新西兰大白兔按照随机数字表法分为PMMA组和磷酸钙组,每组16只,双侧桡骨制造15 mm骨缺损,分别植入PMMA和磷酸钙骨水泥,4、6周后每组选取2只兔子取出骨水泥周围包裹的诱导膜比较膜厚度及血管密度;第4周取出骨水泥并在膜内植入自体松质骨,植骨后8、12周分别通过放射学和组织学评估新生骨形成的情况。结果 1 4、6周时PMMA骨水泥组诱导形成的膜厚度分别为(1 108±26)、(945±42)μm,磷酸钙骨水泥组诱导成膜厚度为(945±34)、(778±22)μm,两组间差异有统计学意义(P<0.05)。PMMA骨水泥诱导的膜血管密度分别为6、3个/cm2,而磷酸钙骨水泥诱导形成的膜血管密度分别为2、2个/cm2。2放射学检测可见植骨后第8、12周PMMA组成骨按Lane-Sandhu X线评分(2.84±0.36)、(4.22±0.54)优于磷酸钙组(1.98±0.15)、(3.16±0.23),两组间差异有统计学意义(P<0.05).3第8、12周组织学观察PMMA组按Nilsson组织学评分标准进行评分(3.14±0.29)、(4.63±0.37),成骨优于磷酸钙组(2.10±0.18)、(3.59±0.21),两组间差异有统计学意义(P<0.05)。结论在新西兰兔桡骨骨缺损处PMMA骨水泥诱导形成的生物膜较磷酸钙骨水泥诱导形成的生物膜具有更强的促血管化和成骨活性。

Objective To compare the structure and osteogenic activity between polymethyl methacrylate （PMMA） bone cement-induced membrane and calcium phosphate bone cement-induced membrane. Methods Totally, 32 healthy adult New Zealand white rabbits were randomly divided into a PMMA bone cement group and a calcium phosphate bone cement group, 16 rabbits in each group. Bone defects （15 mm） were formed on the bilateral radius of the rabbits, and then PMMA or calcium phosphate bone cement was implanted. In the 4th and 6th weeks, the induced membranes were taken out from 2 rabbits in each group to observe the film thickness and blood vessel density. The bone cement was removed in the 4th week and autogenous cancellous bone was implanted. In the 8th and 12th weeks, new bone formation was evaluated by radiological and histological observation. Results The thickness of the induced membranes in the PMMA bone cement group was 1 108 ± 26 μm and 945 ± 42 μm in the 4th and 6th weeks, respectively, while that was 945 ± 34 μm and 778 ± 22 μm in the calcium phosphate bone cement group （ P 〈 0.05 ）. In the 4th and 6th weeks, the blood vessel density was 6/cm2 and 3/cm2 in the PMMA bone cement group, and 2/cm2 and 2/cm2 in the calcium phosphate bone cement group, respectively. The radiological observation showed that Lane-Sandhu X-ray scores （2.84 ± 0. 36, 4.22 ± 0.54） of the PMMA bone cement group in the 8th and 12th weeks were better than those （1.98 ±0.15, 1.98 ±0.23） of the calcium phosphate bone cement group （ P 〈 0.05 ）. The histological observation showed that the Nilsson histological scores （3.14 ± 0.29, 4.63 ± 0.37） of the PMMA bone cement group in the 8th and 12th weeks were better than those （2.10 ± 0. 18, 3.59 ± 0.21 ） of the calcium phosphate bone cement group （P 〈 0. 05 ）. Conclusion The PMMA bone cement-induced membrane shows better vascularization capability and osteogenic activity than the calcium phosphate bone cement-induced membrane.