异体DBM复合rhBMP-2修复兔桡骨缺损的实验研究

目的探讨异体脱钙骨基质（demineralized bonematrix，DBM）复合重组人骨形态发生蛋白2（reconstruction humn bonemorphology protein-2，rhBMP-2）修复节段性骨缺损的能力。方法48只新西兰大白兔采用桡骨15mm节段性骨缺损模型，随机分为3组，A组植入异体DBM与rhBMP-2复合材料，B组植入异体DBM，C组为空白对照组。术后4周、8周、12周、16周．进行放射学和组织学检查。结果A组：术后4周宿主结缔组织长入植骨材料内的骨小梁间，并有岛状新生软骨、骨组织形成；术后8周，新生软骨及骨形成并融合成片；术后12周，新骨改建成熟，但仍能见到植骨材料；术后16周，管状骨结构形成，髓腔再通。B组：术后4周，植骨材料周围有软骨形成；术后8周，大量软骨形成；术后12周，大片状骨形成；术后16周，有髓腔形成。C组：各时问点仅见有纤维结缔组织，只在两端有新骨形成。X片示A组成骨量大，新骨改建、成熟迅速，术后16周全部达骨性愈合。B组成骨量少，仅2例达骨性愈合。C组未见骨性愈合。结论异体DBM复合rhBMP-2材料通过骨诱导和骨传导两种方式修复骨缺损，是一种较理想、具有高效成骨活性的植骨材料。

A Experimental Study of the Efficacy of a Demineralized Bone Matrix Allograft/bBMP Composite Graft in Healing of Rabbit Segmental Radial Defect in Rabbits

Objective To evaluate the efficacy of a demineralized bone matrix allograft/rhBMP-2 composite graft in healing of segmental defect of a radium.Methods 48 rabbits were underwent unilateral radial osteotomies with creation of a 1.5 centimeter defect.They were divided into three groups A,B,C randomly,the defects in group A were received demineralized bone matrix allograft/rhBMP-2(4 mg) composite graft,that in group B were received demineralized bone matrix allograft,that in group C were kept untreated as acontrol.Subjects were underwent monthly radiographs and were killed at four,eight,twelve,and sixteen weeks.Regenerate bone was studied by histology. Results All sixteen DBM+rhBMP-2 radii and only two of sixteen of DBM radii were progressed to radiographic union,compared.Histology revealed that microscopic evidence of normal bone healing in DBM+rhBMP-2 radii,whereas most DBM radii demonstrated nonunions.Conclusion The DBM+rhBMP-2 composite implants is more effective in healing of critical-sized segmental defects than DBM alone in this rabbit model.DBM+rhBMP-2 composite graft is a safe and effective bone graft substitute.