摘要
目的:观察菱形孔隙及方形孔隙两种不同几何形状多孔层设计股骨柄假体的生物学固定效果,分析孔隙几何形状对假体生物学固定的影响。方法:于2003-03/2004-04在中山大学医学部动物中心完成全部实验过程。纳入24只成年杂种犬,雌雄不拘,以随机数字表法均分为2组,即菱形孔隙组及方形孔隙组,各12只。自行设计完成犬骨重建型股骨柄假体,将股骨柄假体近2/3段表层改成两种不同几何形状的粗大多孔层结构,钛丝表面假体,钛丝直径改为1.0mm,孔径加大至5.0mm,孔隙度可达80%。菱形孔隙组钛丝沿股骨假体柄呈螺旋形排列并斜形相交,方形孔隙组钛丝沿股骨假体柄纵横排列并直角相交。均将假体表面孔隙内充填自体股骨头颈骨质制成的骨泥后,行右侧人工股骨头置换术。术后6个月行X射线摄片、组织学检查及生物力学测试,以股骨近端骨吸收情况、新生骨长入深度及孔隙充满度、假体-骨界面最大剪切强度测量为评价指标,了解假体内外成骨和固定情况。结果:菱形孔隙组及方形孔隙组各12只,实验中手术不成功或术后生存不够观察时间的均予实验过程中随时补足,最终每组12只进入结果分析。①组织学观察显示菱形孔隙组多孔层孔隙内最大骨长入深度及孔隙内新生骨平均充盈率均优于方形孔隙组(3000,2450μm;96.2%,71.6%)。②菱形孔隙组假体-骨界面最大剪切强度高于方形孔隙组,差异有显著性意义[(8.57±0.51),(3.15±0.41)N/mm2,P<0.01]。③菱形孔隙组6个月标本肉眼及X射线观察股骨近端无明显骨吸收,优于方形孔隙组;所有实验犬术后伤口缝线任其自行脱落,除1只伤口感染并于术后17d死亡外,余实验犬均伤口愈合良好,未出现不良反应。结论:股骨柄假体表面不同几何形状多孔层设计能影响其生物学固定效果,菱形孔隙设计优于方形孔隙。
AIM： To observe the effect of biological fixation of femur haft prosthesis with multilayer macropores coating by two different designs of geometry and analyze the effect of pore geometry on the biological fixation of prosthesis.
METHODS： The experiment was conducted in the animal center of Department of Medicine, Sun Yat-sen University from March 2003 to April 2004. Twenty-four adult mongrel dogs of either sex were selected and randomly divided into two groups： rhombus design and square design with 12 animals in each group. Reconstruction of femoral stem prostheses was designed personally, proximal 2/3 surfaces of which were reformed by thick multilayer stereo pore structure of two different designs of geometry and titanium wire surface of 1.0 mm in diameter. The pore diameter was enlarged to 5.0 mm, and porosity reached 80%. The titanium wire of the rhombus group was twisted arranged and intersected along the prostheses, white the wire of the square group was arranged in length and breadth and intersected in straight angle along the prostheses. After the autogenous bone mud of femoral head and neck were filled in the pore of the prostheses surface, the right femoral head replacement was carried out. The roentgenograms, histological examination and biomechanical tests were undertaken dynamically at the 6^th month after operation. The indexes included bone resorption in femur proximate, new-bone growing depth and pore-filled extent and the maximum shear strength of prosthesis-bone interface were evaluated to observe the bone formation and fixation in the exterior and interior sides of the prostheses.
RESULTS： After the animal supplement for the unsuccessful operation or died after operation, 12 dogs of each group were involved in the result analysis, （1） Histological examination showed that the maximum bone inserting depth and average engorging ratio of newly formed bone in the rhombus group were better than the square group （3 000, 2 450 μm; 96.2%, 71,6%）, （2）The maximum shear strength of higher than the square group significantly [（8.57±0.51）, （3.15± 0.41） N/mm^2, P 〈 0.01], （3）Both unaided eye and roentgenograms observation displayed that the rhombus group were superior over the square group with no obvious bone resorption in femur proximate in the sixth month specimens; All the suture line of the dogs after operation scaled naturally. Except one dog died of wound infection at the 17^th day after operation, all dogs＇ wound healed well without any adverse effect.
CONCLUSION： Multilayer macropores coating by different geometry could influence the biological fixation of femoral haft prosthesis; moreover, rhombus design of geometry is better than square design.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第9期1605-1608,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
广东省科技计划项目(2004A30201003)~~
