聚乳酸管引导性骨再生修复骨缺损的实验研究

Experimental study of polylactic acid tube guided bone regeneration in the healing course of segmental long bone defects

目的 观察可降解性材料膜管引导长管状骨骨再生的现象 ,并探讨其作用机制。方法 6 0只成年新西兰大白兔双侧桡骨中上段截去 15mm ,包括骨膜 ,造成骨缺损。左侧为实验侧 ,采用聚乳酸管桥接 ,制作长管状骨引导性骨再生动物模型 ,右侧骨缺损不做处理作为对照。 6 0只兔随机分为 2组 :A组 12只兔分别于术后 1、2、4、8、12、16周时摄X线片观察 ;B组 4 8只兔随机分为 6组 ,分别于术后 1、2、4、8、12、16周时处死取材 ,进行组织学观察。结果 A组术后 1、2周时实验侧与对照侧无明显差异 ,实验侧 4周时有骨痂开始形成 ,16周时有 10例完成骨性连接、髓腔再通及板层骨改建。对照侧 4周时骨痂生长不明显 ,16周时无 1例愈合。B组实验侧 1周时即有骨及软骨再生 ,16周时在形态学特征、组织学特性方面均类似于正常骨 ,对照侧 16周时只在两截骨端有少量软骨细胞 ,缺损区为纤维组织充填。结论 聚乳酸管能够成功引导骨再生 。

Objective To observe bone regeneration guided by polylactic acid tube (PLA) in the healing course of long bone defects and study the mechanism of guided bone regeneration(GBR).?Methods Sixty New Zealand rabbits aged 1 1.5 year old were involved in this study. Fifteen mm bony and periosteous defect was produced in both radius of all rabbits. The left defect as experimental side was bridged with PLA tube,the right side was untreated as control side. Sixty rabbits were randomly divided into 2 groups:?group A and group B,at postoperative week 1,2,4,8,12,16,bone repair was assessed by roentgenography and histology separately.?Results There was no obvious difference between experimental side and control side at the 1st and the 2nd week in group A. New bony tissue was induced in experimental side at postoperative the 4th week,10 radial defects were repaired successfully in experimental side of 12 radius at the 16th week after surgery,whereas all control sides showed non union. The histological study revealed bony cell and chondrocytes growing at the 1st week after operation in group B in experimental side,10 of 12 radial defects were united with massive bone formation and the bone marrow canal was recanalized at 16th week postoperatively, but in control side there were only a few chondrocytes on the cut end of the radius and the defects were filled with connective tissue.?Conclusion It is suggested that the bone defect was repaired successfully by GBR with PLA at the 16th week after operation,GBR technique has great future for clinical use in repairing bone defect and non union.