组织工程化骨替代材料的评价及其在修复骨肿瘤性骨缺损中的应用

目的制备和综合评价组织工程化骨替代材料并用于修复骨肿瘤所导致的骨缺损。方法制备狗和人的异体脱钙骨基质颗粒(DBM),提取牛骨形成蛋白(bBMP)并经成骨诱导活性测定,将bBMP与DBM用直接掺和的方法复合后,再与骨水泥(BC)混合制成组织工程化复合材料,进行综合评价后备用。56例下肢骨肿瘤患者在微波诱导高温原位灭活后,应用组织工程化复合材料对遗留的骨缺损进行修复重建。结果bBMP、DBM和BC组织工程化复合骨修复替代材料具有良好的生物相容性、很强的生物力学强度和成骨诱导活性,并且具有良好的粘合性和可塑形性。临床应用56例,经平均9个月的随访,效果良好且无任何不良反应。患肢膝关节功能评价,优52例(93%),良4例(7%),优良率100%。结论bBMP、DBM和BC组织工程化复合骨修复替代材料是目前修复骨缺损理想的产品,有广阔的临床应用前景。

Repair of bone defects caused by bone tumors with tissue engineer material of bone morphogenetic protein,decalcified bone matrix and bone cement

Objective To prepare and evaluate the tissue en gineer material of bovine bone morph ogenetic protein(bBMP ),decalcified bone matrix(DBM)and bone cement (BC)and to repair the bone defects caused by bone tumors.Methods The canine and human DBM was prepared and the bBMP was extracted a nd its bone induction activity was determined.First mix bBMP and DBM toge ther,then add the BC and finally the composite material was e xamined by biocompatibility,biome chanics,scan electron microscope a nd determination of bone inductive activity.Fifty-six patients who had had the bone tumor were treated with microwave-induced hyperthermia an d the bone defects were repaired with the composite material.Results The composite material had very stro ng biomechanical intensity,excell ent biocompatilibity.All of the fifty-six patients were followed up with an average of nine months.The re sults of the knee of the patients were that fifty-two patients were excellent (93%)and four patients were good(7%).Conclusion The tissue engineer material of bovine bone morphogenetic protein,de-calcified bone matrix and bone cemen t is a ideal composite material for th e repair of bone defects.