摘要
目的探讨骨形态发生蛋白(BMP)与植入体的复合方法及植入体复合BMP后对骨-植入体界面的骨长入与结合强度的作用,为人工关节生物固定方法的改进提供实验依据。方法取12只成年杂种犬,随机分成三个时间组,取双侧股骨为种植区。将多孔金属表面(PCA)植入体、BMP2复合PCA植入体、喷涂羟基磷灰石(HA)的PCA植入体及喷涂HA的光滑金属表面植入体植入犬皮质骨后,分别于术后4、8及12周取出,通过X线摄片、不脱钙骨磨片、荧光显微镜、软X线摄片、骨计量学等方法对骨-植入体界面进行组织学和形态学的综合观察分析。结果各种植入体均具有良好的组织相容性。植入体表面复合BMP后,骨长入植入体界面的时间早于其它方法,新生骨组织成熟也较早。各时间段BMP复合PCA植入体组的新生骨形成率均较其它组高,但仅在4周时差异有显著性(P<0.05)。结论实验中采用的BMP与植入体的复合方法简单有效,BMP的应用可使骨与假体界面之间较早达到牢固固定。HA涂层方法能够促进骨组织长入及增强骨-植入体界面结合强度,并在中晚期有一定的优势,但是其喷涂工艺对固定效果有较大的影响,在假体的制造过程中应予以重视。
Objective To promote the clinical practice of bone morphogenetic proteins (BMP) coated prosthesis in order to improve its biological fixation. Methods There were 12 healthy mongrels, weighted from 20 to 25 kg. They were randomly divided into 3 groups according to the scarified time. The bilateral femurs were adopted as the graft areas, and 4 kinds of implant were transplanted into each femur randomly. The transplant consisted of porous-coated anatomic(PCA group), PCA combined with BMP (BMP group), PCA combined with hydroxyapatite(Composite group), and polish PCA combined with HA (HA group). The femurs of the mongrels were retrieved at the 4th, 8th and 12th week respectively. Bone ingrowth and shear strength between the interfaces of the bone-implant were studied, using X-ray, soft X-ray, fluorescence tag, non-decalcification ground section, computer-aided image analysis, and histological examinations. Results By gross observation, the composite for the group of PCA with BMP was the most stable in all the experimental groups. All implants showed good histocompatibility, the bone ingrowth on the implant surface appeared earlier in the BMP group than any others, and so did the maturation of new bone. At 4th week, the percent of new bone formation in the BMP group was 26.58%±4.56%, which was also much higher than PCA group (18.28%±2.46%), Composite group (17.23%±2.11%), and HA group(16.89%±3.13%) through the means of non-decalcified ground section and computer aided image analysis, and the difference was of statistical significance(P< 0.05). However, the difference of the new bone formation percent was of no statistical significant at 8th and 12th week(P >0.05). Conclusion The composite of BMP to the PCA is effective and feasible procedure, which could increase biological fixation of the interfaces between the bone and implant. Furthermore, HA coating is also an effective method of prosthesis surface treatment in order to improve bone ingrowth and enhance the interface shear strength, and the technique of HA coating is an essential factor in processing the prosthesis.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2004年第3期179-183,共5页
Chinese Journal of Orthopaedics
基金
北京市科委科学基金资助项目(200100324)
