四种自体植入物作月骨替代物的对比实验研究

目的 对比研究四种自体植入物置入动物关节腔后的组织形态学变化,为治疗Kienbock病提供可行的月骨替代物。方法 选新西兰白兔60只,按手术前后随机分为A组(骨膜组)、B组(复合体组)、C组(BMP-松质骨粒复合体组)和D组(对照组),每组15只。将四种植入物分别植入兔关节腔内,术后3、6、12、16和24周时取材,组织学观察骨形成并测量骨密度值(bone mineral density,BMD)。结果 A组、B组均有骨和软骨形成,后者尤为明显;C组仅有骨形成;D组呈玻璃样变性,无骨形成。标本的 BMD值经统计学方差分析,A组、B组和D组间有非常明显的差别(P<0.01),B组与C组间无明显差别(P>0.05)。结论 BMP-松质骨粒复合体组骨形成较强;复合体组在骨膜、松质骨匀浆中多种骨形成诱导因子作用下可形成大量骨和软骨,两种自体植入物可用作月骨替代物。

A comparative experimental study on 4 sorts of autologous implants as substitute for lunate

Objective To study and compare morphological and histological changes after four sorts of autologous implants was implanted into articular cavity in rabbits, and provide a better substitute for the lunate for treatment of Kienbock s disease. Methods Sixty healthy New Zealand white rabbits were randomly divided into four groups: periosteum group A, composite group B, Bone morphgenetic protein (BMP)-spongiosa grains composite group C, and control group D, 15 in each. The 4 sorts of implants were placed into articular cavity of the knee in rabbits respectively. The changes of bone formation were examined and bone mineral density (BMD) measured on 3,6,12,16 and 24 weeks after the opertaion. Results There was cartilage and bony forming in group A and B, especially in group B. There was only bony forming in group C and hyaline degeneration with no bone formation in group D. There was statistically significant difference between group A, B and D. No statistically significant difference between group B and C was found. Conclusion These results demonstrate that the BMP- spongiosa grains composite group is of stronger bone-forming effects. The composite group B, under the induction of periosteum and bone-forming factors in spongiosa homogenate, can produce much cartilage and bone and can be used as the substitute for the lunate.