新型可塑形同种骨修复材料修复运动性关节软骨损伤

A novel plastic homogeneous bone repair material for sport-related articular cartilage injury

背景:目前临床上对于可塑形骨修复材料的基本组成及制备方法存在较大争议,且对于其在运动性关节软骨损伤中的修复效果尚缺乏报道。目的:分析新型可塑形同种骨修复材料修复运动性关节软骨损伤的效果。方法:取36只新西兰大白兔,建立关节软骨损伤模型后,随机分为2组,实验组采用新型可塑形同种骨修复材料(为脱钙骨基质与骨胶原复合物)修复,对照组采用透明质酸钠凝胶修复,修复后3周,采用动物实验跑台模拟运动员受伤后的运动训练,30 min/次,连续运动5次。修复后16,18,20周,进行缺损部位组织学观察。结果与结论:(1)修复后16周,实验组缺损部位修复良好,周围未见明显炎症反应,且与周围组织出现融合;对照组修复部位存在一裂隙,材料与间质部位相互融合,修复部位周围未见炎症反应;(2)修复后18周,实验组损伤部位可见排列紧密的脱细胞骨基质颗粒,纤维结缔组织相对较少,宿主骨边缘存在新骨;对照组损伤部位愈合,但新骨相对较少;(3)修复后20周,实验组损伤部位被纤维结缔组织填充,纤维结缔组织内存在大量的血管长入,周围宿主骨边缘可见少量新生组织;对照组损伤部位得到改善,但未见新生血管;(4)结果表明,新型可塑形同种骨修复材料可促进运动性关节软骨损伤的修复且排斥反应小。

BACKGROUND：Currently, the components and preparation methodsof plastic bone repair materials remaincontroversial, andrare studies focus ontheirrepair effectsonsport-related articular cartilage injury. OBJECTIVE：To analyze the effect ofanovel plastic homogeneous bone repair materialto repair sport-related articular cartilage injury. METHODS：Thirty-six New Zealand rabbits were selected to prepare articular cartilage injury models,and wererandomized into two groups.Modelrabbits were repaired withthenovel plastic homogeneous bone material （acompositeof demineralized bone matrix and colagen） as experimental group, while the others repaired with sodium hyaluronate gel as control group. At 3 weeks after repair, treadmil system was utilized tostimulate sports training after athlete injury,for five consecutive sessions of 30 minutes each. At 16, 18 and 20 weeks after repair, the defect region was observedhistologicaly. RESULTS AND CONCLUSION：At 16 weeks after repair, the defect region healedweland integrated with the surrounding tissues, and no significant inflammatory reaction appeared around the material in the experimental group;in the control group,afissureappeared at the defect regionbutwith no inflammatory reaction, and the material integrated with the interstitial site. At 18 weeks after repair, closely arranged acelular bone matrix could be found in the defect region, fibrous connective tissues were fewer, and there was a new bone formation around the edge of host bone in theexperimental group; the defect region healed, but new boneswerefewer in the control group. At 20 weeks after repair, the defect regionin the experimental groupwas filed with fibrous connective tissues,in whichthere were numerous new blood vessels,anda fewofnew tissuesappearedaround the edge of host bone; the defect regionin the control groupwas improvedandno neovascularizationoccurred. These findings suggest thatthenovel plastic homogeneous bone material can promote the repair of sport-related articular cartilage injury withless rejection reactions.