鸸鹋股骨头坏死两种修复方式骨显微结构变化的比较

Comparisons of Emu Necrotic Femoral Head Micro Structure Repaired in Two Different Methods

目的比较鸸鹋股骨头坏死不同造模方式股骨头骨显微结构的差异。方法成年鸸鹋15只,分为3组,每组5只,均以右侧股骨头为研究对象:第1组为正常组,不做处理;第2组为冷冻建立模型组,通过液氮和射频冷热交替的方式建立股骨头坏死塌陷模型;第3组为乙醇建立模型组,通过局部注射无水乙醇的方式建立股骨头坏死塌陷前模型。造模成功后分别取各个实验动物右侧股骨标本,股骨标本近端行显微计算机断层摄影扫描,并进行3组标本骨显微结构参数的比较和统计分析。结果所有鸸鹋术后无明显感染征象,未发生实验动物异常死亡。与正常组相比,冷冻建立模型组骨小梁改建后骨矿物量(P=0.015)和骨小梁间距(P=0.001)明显减少,骨体积比(P=0.036)、骨表面积/体积比(P=0.032)和骨小梁数目明显增加(P=0.002),骨小梁厚度差异无统计学意义(P=0.060)。与正常组相比,乙醇建立模型组骨小梁改建后骨矿物量明显增高(P=0.001)、骨小梁厚度(P=0.003)和骨表面积/体积比(P=0.022)明显增加,骨小梁间距(P=0.001)和骨体积比(P=0.001)明显减少,骨小梁数目差异无统计学意义(P=0.143)。与乙醇建立模型组比较,冷冻建立模型组的骨矿物量(P=0.001)、骨小梁厚度(P=0.001)和骨体积比(P=0.001)明显减低,骨表面积/体积比(P=0.022)和骨小梁数目(P=0.003)明显增高,骨小梁间距差异无统计学意义(P=0.398)。结论不同修复方式可造成重建后股骨头负重区骨小梁结构及骨密度的不同,产生的重建骨小梁骨质量也不同。

Objective To compare emu necrotic femoral head micro structure repaired in two different methods. Methods Fifteen adult emus were divided into 3 groups （ all n = 5 ）, and the right femoral head was selected to research. The first group was the control group; in the second group, femoral head necrosis was made by cryogen with liquid nitrogen; and in the third group, femoral head necrosis was made by local pure ethanol injection. Right femurs were taken for micro CT examination, then femoral head micro structures were compared among these three groups. Results No infection or unexpected death was found in all groups. Compared with normal group, necrotic femoral heads in cryogen group showed that bone mineral density significantly reduced af- ter repaire （P =0. 015）, trabecular space significantly reduced （P =0. 001 ）, bone volume fraction significantly enlarged （ P = 0. 036）, bone surface/volume fraction （ P = 0. 032） and trabecular numbers （ P = 0. 002） significantly enlarged ; trabecular thickness showed no significant difference （P = 0. 060） . Compared with control group, necrotic femoral heads in ethanol group showed that bone mineral density significantly enlarged after re- paire （ P = 0. 001 ）, trabecular thickness （ P = 0. 003 ） and bone surface/volume fraction （ P = 0. 022 ） signifi- cantly enlarged, trabecular space （ P = 0. 001 ） and bone volume fraction （ P = 0. 001 ） significantly reduced ; the trabecular numbers showed no significant difference （P = 0.143） . Compared with ethanol group, necrotic femoral heads in cryogen group showed significant lower bone mineral density after repair （P = 0. 001 ）, significantly lower bone volume fraction （ P = 0. 001 ）, significantly lower trabecular thickness （ P = 0. 001 ）, significantly higher bone surface/volume fraction （ P = 0. 022 ） and higher trabecular numbers （ P = 0, 003 ） ; the tra- becular space showed no significant difference （ P = 0. 398） . Conclusion Different repair methods make re- constructed femoral head weight bearing area have different bone structure and bone mineral density, along with different bone trabecular quality.