生物活性纳米骨浆复合自体红骨髓经皮注射修复实验性兔尺骨骨不连*

摘要背景：纳米科技的发展和对自体红骨髓的深入认识为治疗骨不连提供了新的思路。目的：探讨经皮注射生物活性纳米骨浆复合自体红骨髓微创治疗兔尺骨骨不连的可行性。方法：取4月龄新西兰大白兔制备尺骨不连模型成功后随机分为4组，于骨不连处经皮植入生物活性纳米骨浆复合自体浓缩红骨髓、生物活性纳米骨浆、自体浓缩红骨髓或不做任何处理(空白对照组)。术后进行X射线片检查并进行放射学骨愈合评分，12周动物处死后取材，进行大体观察，生物力学测定和组织学观察。结果与结论：放射学评分显示新骨形成的速度：生物活性纳米骨浆复合自体浓缩红骨髓组>生物活性纳米骨浆组>自体浓缩红骨髓组>空白对照组(P < 0.01)。生物力学测定显示生物活性纳米骨浆复合自体浓缩红骨髓形成新骨的生物力学强度高于生物活性纳米骨浆(P < 0.01)，但低于正常骨组织(P < 0.01)。组织学观察显示生物活性纳米骨浆复合自体浓缩红骨髓组新生骨量较多，骨不连处形成了新的骨性连接；生物活性纳米骨浆组新生骨量多，骨不连处有软骨团形成，部分形成骨性连接；自体浓缩红骨髓组有部分软骨样组织形成，无骨性连接；空白对照组尺骨骨不连处纤维组织形成，无骨性连接。结果提示生物活性纳米骨浆复合自体浓缩红骨髓后具有一定的骨诱导作用，注入体内后成骨速度、形成新骨的质量及力学强度明显优于单纯的纳米骨浆或红骨髓，可用于经皮注射修复实验性骨不连。关键词：生物活性纳米骨浆；红骨髓；尺骨；骨不连；经皮注射；纳米生物材料doi:10.3969/j.issn.1673-8225.2010.21.001

Repair of the rabbit ulnar bone nonunion through percutaneous injection of autologous red bone marrow and bioactive nano-bone putty complex

AbstractBACKGROUND: The development of nanotechnology and the deepening understanding of autogenous bone marrow provide a new idea for repairing bone nonunion. OBJECTIVE: To discuss the feasibility of repairing bone nonunion through percutaneous injection of autologous red bone marrow and bioactive nano-bone putty complex.METHODS: New Zealand rabbits were prepared for ulnar bone nonunion models and were randomly divided into 4 groups; the red bone marrow + bioactive nano-bone putty, bioactive nano-bone putty, and enriched red bone marrow were percutaneously injected into the rabbit ulnar bone nonunion. There was no treatment in the blank control group. The repair capability was assessed by radiographic examination, and the gross observation, biomechanics measurement, and histological observation were performed at 12 weeks after operation. RESULTS AND CONCLUSION: Radiological assessment showed that the new bone formation was: enriched red bone marrow + bioactive nano-bone putty group > bioactive nano-bone putty group > enriched red bone marrow group > blank control group (P < 0.01). The biomechanics measurement displayed that biomechanical strength of the enriched red bone marrow + bioactive nano-bone putty group was greater than that of the bioactive nano-bone putty group (P < 0.01), but smaller than normal bone tissues (P < 0.01). The histologic check showed that in enriched red bone marrow + bioactive nano-bone putty group, there were a great number of osteoblasts and new mass, and bone union appeared in the place of bone nonunion. In enriched red bone marrow group, few formation of new bone in the place of bone nonunion which finally filled with fibrous tissues. There was no formation of new bone in the place of bone nonunion where fibrous tissues were finally filled in the blank control group. The enriched red bone marrow and bioactive nano-bone putty complex exhibit osteoinductive ability, and has a better bone nonunion repair capability than nanobone putty or red marrow used only regarding the bone formation rate, quality and mechanical strength. The complex graft can repair rabbit ulnar bone nonunion through percutaneous injection.