摘要
目的评价骨软骨柱镶嵌移植、骨-骨膜柱镶嵌移植和Ⅱ型胶原骨形态发生蛋白(BMP)复合物3种方法修复关节软骨缺损的生物力学变化,为临床应用提供实验依据。方法将20只成年新西兰兔制成膝关节缺损模型,修复1组在缺损局部镶嵌移植骨软骨柱,修复2组为骨-骨膜柱,修复3组为Ⅱ型胶原BMP复合物,空白组软骨缺损处不作处理,另取4只兔作为正常对照。术后12周取材制成宽3mm、长5mm、厚0·5mm的条状试件进行单向拉伸试验、黏弹性蠕变和松弛试验,所得数据结果进行统计学分析。结果3种方法对关节软骨缺损修复的修复物应力-应变曲线、时间-应力曲线和时间-应变曲线都具有一定的黏弹性表现,与对照组比较差异具有显著性(P<0·01),但较正常组仍有差距(P<0·05),其中修复1组标本力学性能强于修复2组和修复3组(P<0·05)。结论骨软骨柱镶嵌移植、骨-骨膜柱镶嵌移植和Ⅱ型胶原BMP复合物3种方法对关节软骨缺损具有良好的修复作用,骨软骨柱移植近期效果最佳,而Ⅱ型胶原BMP复合物来源广泛,适合修复大面积的关节软骨缺损。
Objective To compare and evaluate the difference of the biomechanical properties between mosaicplasty, free osteoperiosteum transplantation and composite of bone morphogenetic protein（BMP） and type Ⅱ collagen implantation for repairing local osteochondral defect in rabbits＇ knee, for the purpose of proposing the experimental basis for clinical application. Methods Twenty adult New Zealand white rabbits were used for preparing the model of cartilage defect in knee joint. Experiment group 1 were repaired with mosaicplasty, experiment group2 with free osteoperiosteum, experiment group 3 with a composite of bone morphogenetic protein and type Ⅱ collagen, control group with nothing, and four adult New Zealand white rabbits were used as normal control group. At 12 week after operation, one dimension tensile tests, the steer creep tests and relaxation tests were conducted to evaluate the biomechanical properties of the repaired osteochondral defect. Results The repairing issue in the experiment group had the coelasticity properties, and were better than control group of the biomechanical properties, while worse than the normal cartilage. Among the three experiment groups, the biomechanical properties of the repairing issue in experiment groupl were better than the other experiment groups, while the extent of connection between the reparative issue and the adjacent tissue was inferior, especially in the experiment group 3. Condusions Mosaicplasty, free osteoperiosteum transplantation and the composite of BMP and type Ⅱ collagen are feasible for repairing of the cartilage lesion. These methods are beneficial options for clinical application, among which mosaicplasty is the best, while the composite of BMP and type Ⅱ collagen has a extensive source and is suitable for repairing the bigger range osteochondral defect.
出处
《临床骨科杂志》
2006年第3期263-267,共5页
Journal of Clinical Orthopaedics
基金
温州市科技局项目(编号:Y2004018)
关键词
骨移植
镶嵌移植
胶原Ⅱ型
骨形态发生蛋白质类
骨膜
软骨缺损
生物力学
bone trasplantation
mosaicplasty
collagen type Ⅱ
bone morphogenetic proteins
periosteum
cartilage defect
biomechanics
