骨修复中应用的生物降解可吸收材料

BACKGROUND: Because there are many inevitable problems in autologous or allogeneic bone grafting for treatment of bone defects, the application of biodegradable absorbable material is the focus of current research. OBJECTIVE: To evaluate the biological properties of several kinds of bone repair materials and their influence on bone defect repair after implantation. METHODS: PubMed and CNKI databases were retrieved for articles published from 1994 to 2015 by computer. The keywords were “bone defect, biodegradable material, bone graft” in English and Chinese, respectively.  RESULTS AND CONCLUSION: Biodegradable absorbable materials mainly include natural polymer materials, synthetic polymer materials and bio-inorganic materials. Biodegradable absorbable materials have good biocompatibility, and can induce new bone ingrowth after implantation to form good osteo-integration. It has shown a clear advantage in bone repair. A variety of materials combined together can promote the repair of bone defects, which is the development trend of alternative materials for bone repair.      

自固化磷酸钙人工骨Ⅱ修复兔腱-骨损伤的生物力学变化

背景：磷酸钙人工骨与重组人骨形态发生蛋白2在实验中均有成骨诱导作用,有修复腱骨界面损伤的可能。 目的：评估自固化磷酸钙人工骨Ⅱ(含重组人骨形态发生蛋白2)修复兔肩袖腱-骨界面损伤后的生物力学变化。 方法：取27只成年健康家兔,其中3只直接取双侧肩关节腱-骨界面标本作为正常组,余下的24只家兔双侧肩关节接受兔肩袖急性断裂腱-骨止点重建手术,术中实验组12只填塞自固化磷酸钙人工骨Ⅱ,对照组12只不填塞任何药物。分别于术后2,4,8周采集标本行生物力学测试。 结果与结论：实验组各时间点肩袖腱-骨界面最大抗拉强度均高于对照组(P < 0.001),但低于正常组(P < 0.001);实验组术后8周肩袖腱-骨界面刚度高于对照组(P < 0.001),但低于正常组(P < 0.001)。表明自固化磷酸钙人工骨Ⅱ可以在术后早期提高兔腱-骨界面的最大抗拉强度和刚度,增强腱-骨界面结合力,促进腱骨界面愈合。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

可吸收性生物材料PCL在体外与动物体内降解机制的研究

检测了可吸收性生物高分子材料ＰＣＬ在体外，动物体内的特性粘度，数均分子量Ｍｎ及结晶度的变化。探讨该材料在体外与动物体现降解的机制。试验结果表明，降解速率与材料原料分子量无关，降解的临界数均分子量（Ｍｎ）ｃｒ接近于５０００；在该分子量以前材料以水解机制为主并伴有表面酶浸蚀机制；在该分子量以后则以浸蚀机制为主，失重明显，并用扫描电镜图片比较了材料浸蚀前后的表面形态。     

胶原基骨修复材料生物安全性评价

为了评价胶原基骨修复材料的生物安全性,我们将供试品或对照品植入大鼠体内观察相关指标(动物体征观察、血常规检查、免疫器官系数分析、各器官和组织的病理学检查、NK细胞杀伤活性测定、淋巴细胞亚群分析、血清中IL-1、IL-6、TNF-α、免疫球蛋白含量测定)。最终结果显示:各处理组大鼠实验前后精神状态无异常,在血常规检查、免疫器官系数分析、各器官和组织的病理学检查、NK细胞杀伤活性测定、淋巴细胞亚群分析、血清中IL-1、IL-6、TNF-α含量的检测、免疫球蛋白含量检测方面,实验组与对照组相比无显著差异。该材料对大鼠会产生轻微而短暂的刺激作用,但未见明显的炎症反应。     

骨修复材料的研究进展

由于自体骨和异体骨移植治疗骨缺损存在许多不可避免的问题,所以,人们开始研制人工骨修复材料。本文综述了生物陶瓷、胶原、脱钙骨、合成聚合物等骨修复材料的研究和应用现状。作者认为,将几类生物材料复合加工,研制出类似于人体骨组织的材料,将是今后骨修复瓣发展趋。     

创伤和骨外科的可吸收聚乙交酯装置

聚乙醇酸或聚乙交酯（ＰＧＡ）是乙醇酸的聚合物，正常身体代谢期间产生乙醇酸并通称为羟基乙酸。这种聚合物利用自增强（ＳＲ）技术聚合物可以制造出坚固的植入物并在骨折和截骨术的治疗中使用。这些植入物是生物相容的。使用这些可吸收性的植入物可以避免清除植入物的第二次手术和避免不变植入物所能产生的危险     

骨修复材料的研究进展

由于自体骨和异体骨移植治疗骨缺损存在许多不可避免的问题 ,所以 ,人们开始研制人工骨修复材料。本文综述了生物陶瓷、胶原、脱钙骨、合成聚合物等骨修复材料的研究和应用现状。作者认为 ,将几类生物材料复合加工 ,研制出类似于人体骨组织的材料 ,将是今后骨修复材料的发展趋势     

生物材料及细胞外基质与骨形成研究进展

骨修复一直是骨科界的难题之一，许多学者进行了相关研究。近二十多年来，随着生物化学和分子生物学研究的发展，发现细胞的附着与细胞表面的受体及细胞外基质表面的特定位点有关，成骨细胞成骨活性与细胞外基质(extracellar matrix，ECM)有着密切的相关性，ECM的成分包括有机和无机成分两类，对骨形成起着主要作用的有骨形态蛋白(bone morohgenetic proteins，BMP)，纤维粘连蛋白(fibronectin，FN)，层粘蛋白(laminin，LN)，波基结合素(vitronectin，VN)等。     

自固化磷酸钙人工骨Ⅱ型诱导成骨及修复腱骨界面损伤的生物力学分析

背景：自固化磷酸钙人工骨Ⅱ型与重组人骨形态发生蛋白均有一定的成骨诱导作用,存在修复腱骨界面损伤的可能。 目的：探讨自固化磷酸钙人工骨Ⅱ型的成骨诱导作用及修复腱骨界面损伤生物力学情况。 方法：35只成年健康的新西兰白兔,随机选取5只,处死后取双侧肩关节腱骨界面标本作为正常对照。剩余30只构建腱骨界面损伤模型后,随机等分为实验组和模型组,模型组不填塞任何药物,实验组填塞自固化磷酸钙人工骨Ⅱ型进行修复。 结果与结论：填塞自固化磷酸钙人工骨Ⅱ型后,兔损伤腱骨界面明显恢复,且随时间的延长,修复效果更佳,骨形态发生蛋白2表达水平也随之增加,损伤腱骨界面最大抗拉强度以及最大刚度明显增加。表明利用自固化磷酸钙人工骨Ⅱ型复合重组人骨形态发生蛋白对腱骨界面损伤进行修复具有良好的成骨诱导作用,可以促进损伤的修复。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

可吸收内固定材料修复髌骨横断性骨折

BACKGROUND: In recent years, all kinds of absorbable internal fixation materials have been used in the clinical treatment of patellar transverse fractures. OBJECTIVE: To investigate the repairing effect of absorbable internal fixation materials on patellar transverse fractures. METHODS: Totally 102 cases of fresh patellar transverse fractures were included 62 males and 40 females cases, with a mean age of (41.85±11.15) years, and according to treatment methods, they were divided into two groups: observation group (n=52) using absorbable screws for reconstruction and control group (n=50) using Kirschner wire repair. At 12 months after repair, Lysholm knee function score were measured and evaluated, and the occurrence of adverse events was recorded. RESULTS AND CONCLUSION: The knee function score and excellent rate of the observation group were significantly higher than those of the control group (both P < 0.05). In the observation group, there were four cases of fracture displacement, but no skin irritation and other adverse events occurred; in the control group, there were two cases of nonunion and five cases of skin irritation or internal fixation loosening and slippage. Therefore, there was a higher incidence of adverse events in the control group compared with the observation group (P < 0.05). These experimental results show that the use of absorbable screws in the repair of patellar transverse fracture can promote the functional recovery of the knee joint, with good biocompatibility.      

可吸收螺钉与金属螺钉内固定修复踝关节骨折：生物相容性及踝关节功能比较

BACKGROUND: Previous ankle fracture surgery mainly uses the internal fixation materials such as metal screws or Kirschner wire, which can achieve a strong internal fixation, but all need to be taken out in the secondary surgery. In recent years, elastic modulus of biodegradable absorbable screw is identical to that of cancellous bone, and has been widely used in clinic.      

纳米骨粘合剂在骨折固定中的研究进展

纳米骨粘合剂比普通骨粘合剂具有更强的粘合力、刚度和韧性等机械性能以及更好的生物相容性、降解性和骨传导性等生物性能,在临床骨折固定中的应用前景广阔。本文综述了近年来国内外纳米骨粘合剂对骨折固定的研究进展,并展望其发展前景,为粉碎性骨折的治疗提供参考。     

可吸收聚乳酸接骨板的动物实验初步报道

本文报道了可吸收聚乳酸接骨板用于动物实验的初步结果。聚乳酸接骨板为四孔板，抗拉强度３６．２６ｍＰａ，抗弯强度７９．０９ｍＰａ，抗压强度为４９．８８ｍＰａ。用于１８只家兔股骨骨折的结果表明：全部实验动物伤口愈合好，在２－１０周不同观察期内均有聚乳酸接骨板变形、骨折移位现象，其原因可能是聚乳酸接骨板在体内降解较快，尚不能在骨折愈合前起到有效的固定作用。     

小切口克氏针内固定与小切口钢板内固定治疗青年锁骨中段A型骨折的临床疗效比较研究

目的：对比研究小切口克氏针内固定与小切口钢板内固定治疗青年锁骨中段A型骨折的临床疗效。方法选取我院2012年2月~2014年2月收治的82例锁骨中段A型骨折患者,根据患者治疗术式的不同分为克氏针内固定组(40例)和钢板内固定组(42例),其中克氏针内固定组患者选用小切口克氏针内固定,钢板内固定组选用小切口钢板内固定,对比两组患者固定疗效。结果克氏针内固定组患者治疗优良率为85.00%,钢板内固定组患者优良率为85.71%,,两组患者临床疗效差异无统计学意义(P>0.05)。但克氏针内固定组患者骨愈合率为70.00%,钢板内固定组为45.23%,两者差异显著(P<0.05)。结论小切口克氏针内固定及小切口钢板内固定在锁骨骨折治疗工作中均切实可行,各有优势,其中小切口克氏针内固定术中损伤小,患者术后骨愈合快,但其内固定物易出现松动、脱出;而小切口钢板内固定伴有相对较大手术损伤,患者骨愈合较慢,但其内固定稳定性高。因此,在实际治疗工作中,医师需根据患者具体情况来确定手术方案。     

Biodegradation of Titanium Implants After Long-Time Insertion Used for the Treatment of Fractured Upper and Lower Jaws Through Osteosynthesis: Element Analysis by Electron Microscopy and EDX or EELS

Twelve patients underwent an osteosynthesis with titanium to treat upper and lower jaw fractures. Six to 12 months later, the miniplates were removed. Tissue samples were analyzed by light and electron microscopy for detection of a metallosis. The analysis showed new bone formation like callus tissue around the miniplates. In some cases small, rounded deposits and accumulation of colloid-like particles located next to bigger titanium artifacts were detected in the cytoplasm of histiocytes and in the matrix of connective tissue. The titanium was identified by elemental analysis using EDX in SEM as well as by EELS and electron diffraction in TEM. Both kinds of particles contain titanium, but they seem to be different in composition and derivation. The bigger particles seem to consist of metallic titanium and sourced by working on the metallic implants during the implantation itself. On the other hand, the colloidal-like, small, rounded particles in tissue macrophages and outside the cells in the matrix of connective tissue are presumably of other origin; for example, they could be derived from biodegradation and chemical conversion of the metallic implants. The titanium miniplates were examined before and after implantation by using ESCA technique and revealed metallic titanium and different compositions with other elements. The amount of titanium load of the tissue was very low in most cases and presumably not of biomedical relevance.     

Biodegradation of Titanium Implants After Long-Time Insertion Used for the Treatment of Fractured Upper and Lower Jaws Through Osteosynthesis: Element Analysis by Electron Microscopy and EDX or EELS

Twelve patients underwent an osteosynthesis with titanium to treat upper and lower jaw fractures. Six to 12 months later, the miniplates were removed. Tissue samples were analyzed by light and electron microscopy for detection of a metallosis. The analysis showed new bone formation like callus tissue around the miniplates. In some cases small, rounded deposits and accumulation of colloid-like particles located next to bigger titanium artifacts were detected in the cytoplasm of histiocytes and in the matrix of connective tissue. The titanium was identified by elemental analysis using EDX in SEM as well as by EELS and electron diffraction in TEM. Both kinds of particles contain titanium, but they seem to be different in composition and derivation. The bigger particles seem to consist of metallic titanium and sourced by working on the metallic implants during the implantation itself. On the other hand, the colloidal-like, small, rounded particles in tissue macrophages and outside the cells in the matrix of connective tissue are presumably of other origin; for example, they could be derived from biodegradation and chemical conversion of the metallic implants. The titanium miniplates were examined before and after implantation by using ESCA technique and revealed metallic titanium and different compositions with other elements. The amount of titanium load of the tissue was very low in most cases and presumably not of biomedical relevance.