生物膜与带蒂筋膜瓣体内构建组织工程复合体修复兔骨缺损的比较

背景：利用带蒂筋膜瓣包裹法及单纯生物膜包裹构建组织工程骨均能有效促进骨修复,目前缺乏此两方面的对比研究。 目的：观察单纯生物膜包裹及带蒂筋膜瓣包裹法构建组织工程骨修复骨缺损的效果。 方法：制备兔双侧尺骨中段连同骨膜1 cm骨缺损模型,将自体红骨髓接种于含骨形态发生蛋白的骨诱导活性材料制备非细胞型组织工程骨,并植入双侧骨缺损区,左侧采用深筋膜瓣包裹,设为实验组,右侧采用单纯可吸收生物膜包裹,设为对照组。4,8,12,16周后进行X射线检查、大体观察和组织学检查、修复区内骨形态计量分析,并在12周行生物力学检测,比较两组骨缺损修复情况。 结果与结论：实验组X射线片、大体形态和组织学观察、骨小梁及软骨组织形成的数量和速度、成熟骨结构的形成、骨干结构的重塑、骨髓腔的再通、植入物的吸收降解、新生骨小梁面积占修复总面积比值以及最终生物力学强度均明显优于对照组(P < 0.05)。说明以带蒂筋膜瓣为膜材料应用膜引导性骨再生技术修复大段骨缺损,能有效限制纤维结缔组织长入,具有有效快速血管化能力,极大地加快了移植骨转化为自体骨的速度及效果。

Comparison of pedicle fascial flap and absorbable biomembrane in constructing tissue engineering bone to repair rabbit bone defects

BACKGROUND:Tissue engineering bone constructed using both pedicle fascial flap and absorbable biomembrane can effectively promote the bone defect repair, but there is not enough study about the comparison between them. OBJECTIVE:To observe the bone reparative effect of tissue engineering bone wrapped by pedicle fascial flap and by simple biomembrane. METHODS:A 1-cm bone defect model was produced in rabbit bilateral ulna middle segment and periosteum. Autologous red bone marrow was implanted in the osteoinductive absorbing material containing bone morphogenetic protein to prepare uncellular tissue engineering bone, which was then implanted into the bilateral bone defect areas. The left side was wrapped by pedicle fascial flap as the experiment group, while the right side was wrapped by simple absorbable biomembrane as the control group. At 4, 8, 12, 16 weeks after the operation, each group was examined by X-ray radiograph, gross morphology and histological examination, bone shape measurement analysis in the reparative area was performed, the biomechanical detection was done at 12 weeks to compare the repair of bond defect in two groups. RESULTS AND CONCLUSION:The experiment group was superior to the control group regarding the X-ray radiograph, gross morphology and histological inspection, the quantity and the forming speed of bone trabecula and cartilaginous tissues, the formation of mature bone structure, the remodeling of diaphysis structure, the recanalization of cavum ossis, the absorption and degradation of the implant, the ratio of new bone trabecula area to total reparative area and the final biomechanical strength (P < 0.05). The outcomes indicated that the technology of membrane guided bone regeneration using pedical fascial flap to repair large-segment bone defect can restrict the growth of fibrous connective tissue in the reparative process, and promote the effective and fast vascularization, accordingly accelerate the process and the effect of transforming implanted bone to autologous bone.