骨蛋白强化脱钙骨基质板块修复犬长骨节段性骨缺损

Using demineralized bone matrix board augmented with bone proteins to repair segmental bone defect of diaphysis in canine

目的 :研究骨蛋白 (boneprotein ,BP)强化脱钙骨基质 (demineralizedbonematrix ,DBM) (BP/DBM )板块在修复节段性骨缺损中的作用。方法 :在犬双侧桡骨中段各做一 1 5cm的骨膜骨缺损 ,分别植入板块状BP/DBM ,DBM ,自体髂骨块及留置空白 ,观察时间为 4个月。结果 :BP/DBM植入组有 3例完全骨愈合 (3 / 5 ) ,自体骨移植组只有 3例部分骨愈合 ,单纯DBM组及空白组未见骨愈合。生物力学测试 :术后 4个月BP/DBM组新生骨极限压缩强度值最高 ,已达到正常桡骨组织的 48%。BP/DBM组新生骨为成熟的板状骨。结论 :BP/DBM板块可促进节段性骨缺损的修复。

Objective:To investigate the effects of demineralized bone matrix board augmented with bone protein(BP/DBM) on repair of segmental bone defects.Methods:A standard procedure was used to make a 1.5cm long defect bilaterally in the radius of skeletally matured male canines.All of the 20 defects were randomly divided into four subgroups:group Ⅰ,five defects were grafted with board of BP/DBM; group Ⅱ,five defects were grafted with board of DBM;group Ⅲ,autologous cancellous bone was grafted; group Ⅳ,as a control group,the five defects were empty.All defects were internally fixed with stainless plates and screws.In the end of four months after surgery the grafts were harvested and tested the biomechanical strength of new bone.Histological examination of the grafts was performed.Results:The results showed that 3 of 5 bone defects were healed in group Ⅰ,3 of 5 defects were partially healed in group Ⅲ,and none defects was repaired in group Ⅱ and group Ⅳ.Biomechanical test showed that the value of ultimate compressive strength in group Ⅰ was the highest of all groups,the statistical difference was significant between group Ⅰ and group Ⅱ ( P=0.003 ).There was no significant difference between group Ⅰ and group Ⅲ ( P=0.185 ).Histological evaluations showed that most of the DBM was absorbed and substituted by matured new bone in group Ⅰ.Conclusion:BP/DBM can promote the repair of bone defects by three ways:osteoinduction,osteoconduction and stimulation of periosteal.