自体微小颗粒骨复合骨形成蛋白修复兔桡骨缺损

目的探讨自体微小颗粒骨复合I型胶原以及骨形成蛋白(bone morphogenetic protein，BMP)移植修复节段性兔桡骨缺损的效果。方法新西兰大耳白兔56只，切取自体髂骨研磨成微小颗粒，分别与BMP及I型胶原复合，实验分成4组（n=16)。A组：自体微小颗粒骨复合BMP、I型胶原，B组：自体微小颗粒骨复合I型胶原，C组：自体微小颗粒骨，用于修复兔桡骨干1．5cm缺损的动物模型。D组：空白对照组(n=8)，双侧桡骨缺损不作处理。术后2、4、8和12周，行X线片、组织学观察，骨密度及生物力学检测，比较各移植物修复节段性骨缺损的疗效。结果X线片显示，A组术后8周即可使骨缺损完全修复，而B组术后12周使骨缺损完全修复。术后8、12周骨量测定A组成骨量最多，12周生物力学测定显示移植物修复后的骨缺损具有最佳生物力学表现，而C组则不能完全修复骨缺损。结论自体微小颗粒骨复合BMP、I型胶原及自体微小颗粒骨复合I型胶原均能有效修复节段性骨缺损，以复合BMP移植效果更理想。

COMBINED USE OF AUTOLOGOUS MICROMORSELIZED BONE WITH BONE MORPHOGENETIC PROTEIN AND TYPEⅠ COLLAGEN GRAFT IN REPAIRING RABBIT BONE DEFECTS

OBJECTIVE: To study the effect of combined use of autologous micromorselized bone with bone morphogenetic protein(BMP) and type I collagen graft on the treatment of segmental bone defects. METHODS: The bulk bone of rabbit iliac crest was ground into micromorselized bone, which was combined with BMP and type I collagen. The model of 1.5 cm bone defect was established in the middle shaft of the radius. Fifty-six rabbits were assigned to four repairing methods: autologous micromorselized bone graft with BMP and type I collagen, autologous micromorselized bone graft with type I collagen, autologous micromorselized bone graft alone, and control group. The defect-repairing capability of each group was assessed by radiographic, histological, bone densitometry and biomechanical studies. RESULTS: X-ray manifested that at the end of 8 weeks after operation, the bone defect treated with autologous micromorselized bone graft with BMP and type I collagen was repaired completely, and at the end of 12 weeks after operation the bone defect treated with autologous micromorselized bone and type I collagen was cured completely, but the bone defect treated with autologous micromorselized alone was completely repaired. No healing was found in the control group. In the bone densitometry detection, the material with BMP exhibited the strongest defect-repairing capability in terms of amount increased and quality of the new bone at the end of 8 weeks and 12 weeks. The group with BMP has the best mechanical strength of all groups at the end of 12 weeks. CONCLUSION: Autologous micromorselized bone graft with BMP/type I collagen and autologous micromorselized bone graft with type I collagen prove to be effective in repairing segmental bone defects. The autologous micromorselized bone combined BMP and type I collagen is an excellent bone repairing material considering the satisfactory osteogenesis, osteoconduction, and osteoinduction seen in this method.