带蒂筋膜瓣包裹国产多孔钽修复兔桡骨节段性骨缺损实验研究
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摘要
目的观察带蒂筋膜瓣包裹国产多孔钽修复兔桡骨节段性骨缺损的成骨效果。方法选取6~8月龄成年新西兰大白兔60只,雌雄不限,体质量2.5~3.0 kg;制备兔右侧桡骨中段连同骨膜1.5 cm骨缺损模型。实验分为2组,每组30只。实验组于兔右侧前肢切取皮下带蒂筋膜瓣(30 mm×20 mm)包裹多孔钽棒植入桡骨缺损处,对照组于右侧桡骨骨缺损处植入单纯多孔钽棒。于术后当日及4、8、16周行X线片观察,术后4、8、16周取材切片行HE染色及甲苯胺蓝染色观察,术后16周行三点弯曲生物力学测定标本最大载荷力及抗弯曲强度,并行Micro-CT检测及定量分析骨缺损处新生骨体积分数(bone volume fraction,BV/TV),比较两组多孔钽棒体内骨缺损修复能力。结果术后切口均Ⅰ期愈合,无切口感染发生。术后4、8、16周X线片可见两组植入物与宿主骨界面结合越来越牢固,无明显位移,骨折线逐渐消失。HE染色及甲苯胺蓝染色示两组钽-骨界面新生骨组织数量逐渐增多,并沿多孔钽孔隙长入材料内部,骨组织由幼稚到成熟。术后16周,两组三点弯曲试验测定结果示,实验组最大载荷力和抗弯曲强度分别为(96.54±7.21)N、(91.26±1.76)MPa,均明显大于对照组[分别为(82.65±5.65)N、(78.53±1.16)MPa](t=3.715,P=0.004;t=14.801,P=0.000)。Micro-CT扫描观察两组植入物界面、表面均有大量骨组织覆盖,内部不同程度新生骨组织填充;实验组新生骨BV/TV为32.63%±3.56%,显著高于对照组的25.07%±4.34%(t=3.299,P=0.008)。结论带蒂筋膜瓣包裹国产多孔钽可增加局部血运,增强材料骨传导能力,促进节段性骨缺损修复。
Objective To investigate the effect of domestic porous tantalum encapsulated with pedicled fascial flap on repairing of segmental bone defect in rabbits' radius. Methods A total of 60 New Zealand white rabbits(aged 6-8 months and weighing 2.5-3.0 kg) were randomly divided into the experimental group and control group(30 rabbits each group). A 1.5 cm segmental bone defect in right radius was established as the animal model. The porous tantalums encapsulated with pedicled fascial flaps(30 mm×20 mm) were implanted in the created bone defect in the experimental group, and the porous tantalums were only implanted in the control group. X-ray films were observed at the day after operation and at 4, 8, and 16 weeks after operation. Specimens were taken out at 4, 8, and 16 weeks after operation for HE staining and toluidine blue staining observation. The maximum load force and bending strength were detected by three point bending biomechanical test, and the Micro-CT analysis and quantitative analysis of the new bone volume fraction(BV/TV) were performed at 16 weeks after operation to compare the bone defect repair ability in vivo in 2 groups.Results All incisions healed by first intention without wound infection. At 4, 8, and 16 weeks after operation, the X-ray films showed that the implants were well maintained without apparent displacement. As followed with time, the combination between the implants and host bone became more and more closely, and the fracture line gradually disappeared. HE staining and toluidine blue staining showed that new bone mass and maturity gradually increased at the interface and inside materials in 2 groups, and the new bone gradually growed from the interface to internal pore. At16 weeks after operation, the three point bending biomechanical test showed that the maximum load force and bending strength in the experimental were(96.54±7.21) N and(91.26±1.76) MPa respectively, showing significant differences when compared with the control group [(82.65±5.65) N and(78.53±1.16) MPa respectively](t=3.715, P=0.004; t=14.801,P=0.000). And Micro-CT analysis exhibited that there were a large amount of new bone at the interface and the surface of implant materials and inside the materials. The new bone BV/TV in the experimental group(32.63%±3.56%) was significantly higher than that in control group(25.07%±4.34%)(t=3.299, P=0.008). Conclusion Domestic porous tantalum encapsulated with pedicled fascial flap can increase local blood supply, strengthen material bone conduction ability, and promote the segmental bone defect repair.
Objective To investigate the effect of domestic porous tantalum encapsulated with pedicled fascial flap on repairing of segmental bone defect in rabbits' radius. Methods A total of 60 New Zealand white rabbits(aged 6-8 months and weighing 2.5-3.0 kg) were randomly divided into the experimental group and control group(30 rabbits each group). A 1.5 cm segmental bone defect in right radius was established as the animal model. The porous tantalums encapsulated with pedicled fascial flaps(30 mm×20 mm) were implanted in the created bone defect in the experimental group, and the porous tantalums were only implanted in the control group. X-ray films were observed at the day after operation and at 4, 8, and 16 weeks after operation. Specimens were taken out at 4, 8, and 16 weeks after operation for HE staining and toluidine blue staining observation. The maximum load force and bending strength were detected by three point bending biomechanical test, and the Micro-CT analysis and quantitative analysis of the new bone volume fraction(BV/TV) were performed at 16 weeks after operation to compare the bone defect repair ability in vivo in 2 groups.Results All incisions healed by first intention without wound infection. At 4, 8, and 16 weeks after operation, the X-ray films showed that the implants were well maintained without apparent displacement. As followed with time, the combination between the implants and host bone became more and more closely, and the fracture line gradually disappeared. HE staining and toluidine blue staining showed that new bone mass and maturity gradually increased at the interface and inside materials in 2 groups, and the new bone gradually growed from the interface to internal pore. At16 weeks after operation, the three point bending biomechanical test showed that the maximum load force and bending strength in the experimental were(96.54±7.21) N and(91.26±1.76) MPa respectively, showing significant differences when compared with the control group [(82.65±5.65) N and(78.53±1.16) MPa respectively](t=3.715, P=0.004; t=14.801,P=0.000). And Micro-CT analysis exhibited that there were a large amount of new bone at the interface and the surface of implant materials and inside the materials. The new bone BV/TV in the experimental group(32.63%±3.56%) was significantly higher than that in control group(25.07%±4.34%)(t=3.299, P=0.008). Conclusion Domestic porous tantalum encapsulated with pedicled fascial flap can increase local blood supply, strengthen material bone conduction ability, and promote the segmental bone defect repair.
引文
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2 Paganias CG,Tsakotos GA,Koutsostathis SD,et al.Osseous integration in porous tantalum implants.Indian J Orthop,2012,46(5):505-513.
3Wang Q,Zhang H,Li Q,et al.Biocompatibility and osteogenic properties of porous tantalum.Exp Ther Med,2015,9(3):780-786.
4 Wigfield C,Robertson J,Gill S,et al.Clinical experience with porous tantalum cervical interbody implants in a prospective randomized controlled trial.Br J Neurosurg,2003,17(5):418-425.
5Kamath AF,Lewallen DG,Hanssen AD.Porous tantalum metaphyseal cones for severe tibial bone loss in revision knee arthroplasty:a five to nine-year follow-up.J Bone Joint Surg(Am),2015,97(3):216-223.
6 Ren B,Zhai Z,Guo K,et al.The application of porous tantalum cylinder to the repair of comminuted bone defects:a study of rabbit firearm injuries.Int J Clin Exp Med,2015,8(4):5055-5064.
7王茜,张辉,耿丽鑫,等.国产多孔钽复合MG63细胞培养Col-1、OC和OPN蛋白表达及意义.中国矫形外科杂志,2015,23(5):441-449.
8 李琪佳,王茜,甘洪全,等.多孔钽材料细胞毒性、生物相容性及体内成骨性研究.中华骨科杂志,2014,34(9):954-961.
9耿丽鑫,甘洪全,王茜,等.国产多孔钽对成骨细胞生物相容性及其相关成骨基因表达的影响.第三军医大学学报,2014,36(11):1163-1167.
10 王茜,张辉,耿丽鑫,等.MG63细胞与国产多孔钽材料共培养后成骨相关因子的表达研究.中国修复重建外科杂志,2014,28(11):1422-1427.
11赵御森,杨新明,王海波.比较带蒂筋膜瓣与生物膜包绕组织工程骨修复兔超临界骨缺损的实验研究.安徽医科大学学报,2013,48(6):621-625.
12 杨新明,孟宪勇,王耀一,等.带蒂筋膜瓣包裹自体红骨髓组织工程复合体修复四肢大段骨缺损临床研究.中国医师进修杂志,2011,34(23):1-4.
13Periasamy K,Watson WS,Mohammed A,et al.A randomised study of peri-prosthetic bone density after cemented versus trabecular fixation of a polyethylene acetabular component.J Bone Joint Surg(Br),2011,93(8):1033-1044.
14 Sinclair SK,Konz GJ,Dawson JM,et al.Host bone response to polyetheretherketone versus porous tantalum implants for cervical spinal fusion in a goat model.Spine(Phila Pa 1976),2012,37(10):E571-580.
15Bai F,Wang Z,Lu J,et al.The correlation between the internal structure and vascularization of controllable porous bioceramic materials in vivo:a quantitative study.Tissue Eng Part A,2010,16(12):3791-3803.
16 丁冉,吴志宏,邱贵兴,等.选择性激光烧结技术的多孔钛合金支架的骨组织工程学观察.中华医学杂志,2014,94(19):1499-1502.
17Li X,Lin Z,Duan Y,et al.Repair of large segmental bone defects in rabbits using BMP and FGF composite xenogeneic bone.Genet Mol Res,2015,14(2):6395-6400.
18 Kroese-Deutman HC,Vehof JW,Spauwen PH,et al.Orthotopic bone formation in titanium fiber mesh loaded with platelet-rich plasma and placed in segmental defects.Int J Oral Maxillofac Surg,2008,37(6):542-549.
19Roohani-Esfahani SI,Dunstan CR,Davies B,et al.Repairing a critical-sized bone defect with highly porous modified and unmodified baghdadite scaffolds.Acta Biomater,2012,8(11):4162-4172.
20 Kim J,Mc Bride S,Donovan A,et al.Tyrosine-derived polycarbonate scaffolds for bone regeneration in a rabbit radius critical-size defect model.Biomed Mater,2015,10(3):035001.
21刘勇,裴国献,江汕,等.带蒂筋膜瓣促组织工程骨修复兔大段骨缺损的动态研究.中华实验外科杂志,2007,24(6):752.
22 杨新明,石蔚,杜雅坤,等.以带蒂筋膜瓣包裹复合自体红骨髓构建非细胞型组织工程化骨修复兔桡骨缺损.中国组织工程研究与临床,2009,13(46):9050-9054.
23王海波,杨新明,赵御森.带蒂筋膜瓣的稳定性对其促超临界骨缺损成骨作用影响的实验研究.安徽医科大学学报,2013,48(9):1044-1048.
2 Paganias CG,Tsakotos GA,Koutsostathis SD,et al.Osseous integration in porous tantalum implants.Indian J Orthop,2012,46(5):505-513.
3Wang Q,Zhang H,Li Q,et al.Biocompatibility and osteogenic properties of porous tantalum.Exp Ther Med,2015,9(3):780-786.
4 Wigfield C,Robertson J,Gill S,et al.Clinical experience with porous tantalum cervical interbody implants in a prospective randomized controlled trial.Br J Neurosurg,2003,17(5):418-425.
5Kamath AF,Lewallen DG,Hanssen AD.Porous tantalum metaphyseal cones for severe tibial bone loss in revision knee arthroplasty:a five to nine-year follow-up.J Bone Joint Surg(Am),2015,97(3):216-223.
6 Ren B,Zhai Z,Guo K,et al.The application of porous tantalum cylinder to the repair of comminuted bone defects:a study of rabbit firearm injuries.Int J Clin Exp Med,2015,8(4):5055-5064.
7王茜,张辉,耿丽鑫,等.国产多孔钽复合MG63细胞培养Col-1、OC和OPN蛋白表达及意义.中国矫形外科杂志,2015,23(5):441-449.
8 李琪佳,王茜,甘洪全,等.多孔钽材料细胞毒性、生物相容性及体内成骨性研究.中华骨科杂志,2014,34(9):954-961.
9耿丽鑫,甘洪全,王茜,等.国产多孔钽对成骨细胞生物相容性及其相关成骨基因表达的影响.第三军医大学学报,2014,36(11):1163-1167.
10 王茜,张辉,耿丽鑫,等.MG63细胞与国产多孔钽材料共培养后成骨相关因子的表达研究.中国修复重建外科杂志,2014,28(11):1422-1427.
11赵御森,杨新明,王海波.比较带蒂筋膜瓣与生物膜包绕组织工程骨修复兔超临界骨缺损的实验研究.安徽医科大学学报,2013,48(6):621-625.
12 杨新明,孟宪勇,王耀一,等.带蒂筋膜瓣包裹自体红骨髓组织工程复合体修复四肢大段骨缺损临床研究.中国医师进修杂志,2011,34(23):1-4.
13Periasamy K,Watson WS,Mohammed A,et al.A randomised study of peri-prosthetic bone density after cemented versus trabecular fixation of a polyethylene acetabular component.J Bone Joint Surg(Br),2011,93(8):1033-1044.
14 Sinclair SK,Konz GJ,Dawson JM,et al.Host bone response to polyetheretherketone versus porous tantalum implants for cervical spinal fusion in a goat model.Spine(Phila Pa 1976),2012,37(10):E571-580.
15Bai F,Wang Z,Lu J,et al.The correlation between the internal structure and vascularization of controllable porous bioceramic materials in vivo:a quantitative study.Tissue Eng Part A,2010,16(12):3791-3803.
16 丁冉,吴志宏,邱贵兴,等.选择性激光烧结技术的多孔钛合金支架的骨组织工程学观察.中华医学杂志,2014,94(19):1499-1502.
17Li X,Lin Z,Duan Y,et al.Repair of large segmental bone defects in rabbits using BMP and FGF composite xenogeneic bone.Genet Mol Res,2015,14(2):6395-6400.
18 Kroese-Deutman HC,Vehof JW,Spauwen PH,et al.Orthotopic bone formation in titanium fiber mesh loaded with platelet-rich plasma and placed in segmental defects.Int J Oral Maxillofac Surg,2008,37(6):542-549.
19Roohani-Esfahani SI,Dunstan CR,Davies B,et al.Repairing a critical-sized bone defect with highly porous modified and unmodified baghdadite scaffolds.Acta Biomater,2012,8(11):4162-4172.
20 Kim J,Mc Bride S,Donovan A,et al.Tyrosine-derived polycarbonate scaffolds for bone regeneration in a rabbit radius critical-size defect model.Biomed Mater,2015,10(3):035001.
21刘勇,裴国献,江汕,等.带蒂筋膜瓣促组织工程骨修复兔大段骨缺损的动态研究.中华实验外科杂志,2007,24(6):752.
22 杨新明,石蔚,杜雅坤,等.以带蒂筋膜瓣包裹复合自体红骨髓构建非细胞型组织工程化骨修复兔桡骨缺损.中国组织工程研究与临床,2009,13(46):9050-9054.
23王海波,杨新明,赵御森.带蒂筋膜瓣的稳定性对其促超临界骨缺损成骨作用影响的实验研究.安徽医科大学学报,2013,48(9):1044-1048.
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