多孔羟基磷灰石、纤维蛋白和金葡液复合物修复骨缺损的实验研究

REPAIR OF BONE DEFECT WITH COMPOUND OF CORALLINE HYDROXYAPATITE POROUS, FIBRIN SEALANT AND STAPHYLOCOCCUS AUREUS INJECTION

目的 探讨珊瑚多孔羟基磷灰石 (CHAP)、纤维蛋白 (FS)及金葡液 (SAI)复合物修复骨缺损的作用 ,以及作为人工骨移植替代材料的可行性。 方法 采用新西兰大白兔 5 4只在双侧桡骨制备骨缺损模型后分成实验组、对照组及空白组。将 CHAP- FS- SAI复合物植入骨缺损处作为实验组 ,自体骨植入作为对照组 ,空白组不植入任何物质 ;术后 2、4、8和 12周分别取 2只兔行大体标本观察、组织学、X线片观察及生物力学测试 ,比较各组修复骨缺损的能力。 结果 实验组术后 2周见植入物与骨端形成紧密的纤维性连接 ,镜下可见 CHAP周围大量成纤维细胞、软骨细胞及毛细血管增生 ;对照组有少量骨痂形成 ,有软骨细胞、骨母细胞及破骨细胞。 4、8周两组均见大量骨痂形成 ,镜下见软骨细胞钙化 ,组织骨和板层骨。 12周实验组及对照组均见大量成熟的骨细胞及板层骨 ;实验组见植入物完全骨化 ,塑形完全 ,CHAP未完全降解。空白组 12周骨缺损区为纤维瘢痕组织填充 ,镜下主要为大量成纤维细胞。 X线片 2周实验组与对照组有骨痂影 ,4周骨痂影增多。 8周实验组骨缺损消失 ,CHAP分散在骨痂中 ;对照组骨折线消失 ,髓腔开始形成。 12周实验组和对照组骨皮质连续 ,髓腔复通 ,塑形完全。空白组 12周骨缺损区无骨性连接。

Objective To investigate the ability of repairing bone defect with the compound of coralline hydroxyapatite porous (CHAP), fibrin sealant(FS) and staphylococcus aureus injection (SAI), and the feasibility to use the compounds as bone substitute material. Methods The animal model of bone defect was made on the bilateral radius of 54 New Zealand white rabbits, which were randomly divided into the experimental group(the defect was repaired with CHAP FS SAI), control group( with autograft) and blank control group( the defect was left unrepaired) with 18 rabbits in each group. The ability of bone defect repair was evaluated by gross observation, histopathological study, X ray and biomechanical analysis 2, 4, 8 and 12 weeks after repair. Results (1) In the 2nd week, tight fibro connection could be found between the implant and fracture site and there were many fibroblasts and capillary proliferation with many chondrocytes around CHAP in the experimental group, while only a few callus formed, and chondrocytes, osteoblast and osteoclast existed in the control group. (2) In experimental group and control group, a large quantity of callus was found 4 and 8 weeks; ossification of chondrocytes with weave bone formation were found 4 weeks and many osteocytes and weave bones and laminar bones were found 8 weeks. (3) In the 12th week, the complete ossification of implant with well bone remodeling, a large number of mature osteocytes and laminar were found in experimental group and control group,and CHAP still existed in the experimental group; the defect area filled with fibro scar tissue and only many fibroblasts could be seen in blank control group. (4) X ray findings were the following: In experimental and control groups, callus formation could be seen 2 weeks postoperatively, more callus formed 4 weeks, the bone defect area disappeared and CHAP scattered in the callus 8 weeks; the fracture line disappeared and medullary cavity became united( in control group); and in the 12th week, the cortex became continuous, the medullary cavity became united, and remodeling completed, while bone defect was not still united in blank control group. The maximal torque and torsional stiffness in the experimental group is higher than those in the control group 2 weeks ( P< 0.05 ), but there was no significant difference ( P> 0.05 ) between the two groups 4, 8, 12 weeks after repair. Conclusion The compound of CHAP FS SAI has good biological compatibility, and it can be used for one kind of bone substitute material to repair the bone defect.