冻干硬脑膜内骨形成蛋白-自固化磷酸钙复合移植修复骨缺损

背景:骨形成蛋白和自固化磷酸钙各自有着良好的成骨能力,冻干硬脑膜内骨形成蛋白和自固化磷酸钙复合移植存在优化成骨效能的可能性.目的:以冻干硬脑膜为膜材料,观察膜内充填材料骨形成蛋白复合自固化磷酸钙移植修复节段性骨缺损的效果.设计、时间及地点:随机分组设计,动物体内组织病理学对照观察,于2006-07/2007-07在广西医科大学动物实验室完成.对象:健康成年新西兰大白兔28只,雌雄不限,体质量1.5～2.5 kg.方法:实验兔28只,其中4只用于取硬脑膜.其余24只随机分成A,B两大组,每组12只.A组制造双侧兔桡骨中段10 mm的骨缺损.一侧骨缺损用骨形成蛋白、自固化磷酸钙、冻干硬脑膜复合移植修复,为骨形成蛋白组, 另一侧不予处理作为空白对照组.B组制造单侧兔桡骨中段10 mm的骨缺损,用骨髓、自固化磷酸钙、冻干硬脑膜复合移植修复称骨髓组.主要观察指标:于术后第1,2,4,6,8,10,12周分别行双侧桡骨X射线检查.观察骨缺损处的新骨形成及骨修复情况.并于术后第2,4,8,12周切取标本行组织学检查及成骨面积分析.结果:在术后第4,8,12周,骨形成蛋白组的成骨面积大于骨髓组(P＜0.05),而在实验早期(术后2周)两组间差异无显著性意义(P＞0.05);在实验的各个时期,骨形成蛋白组和骨髓组的成骨面积均明显大于空白组(P＜0.01).X射线结果显示,骨形成蛋白组在10～12周出现明显骨痂塑形现象;组织学病理切片结果显示,骨形成蛋白组在12周时桡骨可见成熟骨髓,骨缺损处为成熟的板层骨连接.结论:骨形成蛋白复合自固化磷酸钙与冻干硬脑膜移植具有良好的成骨作用.

Repairing bone defects using bone morphogenetic protein and calcium phosphate cement combined with freeze-dried dura mater

BACKGROUND: Both bone morphogenetic protein (BMP) and calcium phosphate cement (CPC) have excellent osteogenic capability, so, it is possible to optimize osteogenic efficiency by combing BMP, CPC and freeze-dried dura mater (FDDM). OBJECTIVE: To investigate the efficacy of combined BMP-CPC-FDDM in segmental bone defects repairing. DESIGN, TIME AND SETTING: Randomization design and control animal observation were performed at the animal laboratory of the Guangxi Medical University from July 2006 to July 2007. MATERIALS: A total of 28 healthy, adult, New Zealand white rabbits, irrespectively of genders, weighting 1.5-2.5 kg. METHODS: Four rabbits were obtained dura mater. The remained 24 rabbits were randomly divided into 2 groups, with 12animals per group. A group: bilateral 10 mm segmental bone defects were produced in the radius of rabbits. One side defect was repaired with BMP-CPC-FDDM (BMP group). The other side was served as control group. B group: one side 10 mm segmental bone defects were produced in the radius of rabbits, and were repaired with bone marrow-CPC-FDDM (BM group). MAIN OUTCOME MEASURES: X-ray examinations were performed at weeks 1, 2, 4, 6, 8, 10, and 12 after operation to observe the newly formed bone status. The samples were cut for the histology test and analysis of osteogenic area at weeks 2, 4, 8, and 12 after operation. RESULTS: The formed bone area of the BMP group was greater than the BM group at the weeks 4, 8 and 12 after operation (P < 0.05); but at the early period (week 2), the two groups had no obvious difference (P > 0.05). The osteogenic area of the BMP group and the BM group were better than the control group (P < 0.01). X-ray results demonstrated that bony callus moulding appeared obviously at weeks 10-12 in the BMP group. The pathological section revealed that maturate bone marrow could be seen at week 12 after operation, and the bone defect was connected with mature lamellar bone. CONCLUSION: The BMP-CPC-FDDMA has a good osteogenesis.