Abstract:

BACKGROUND: The patients with Kienbock’s disease in stages III and IV, whose lunatum needs to be cut, and how to select eligible surrogate to fill the interspace was the key point to cure Kienbock’s disease.
OBJECTIVE: To evaluate the ability to form bone and cartilage of autologous periosteum wrapping grains of cancellous bone and fibrin sealant combined with bone morphogenetic protein (BMP) compound, in order to explore the feasibility of reconstructing lunate bone for treating Kienbock’s disease.
METHODS: Japanese big ear rabbits were divided into three groups: periostum wrapping grains of cancellous bone and fibrin sealant combined with BMP were respectively implanted in rabbit knee joint suprapatellar bursa; grains of cancellous bone were wrapped with bone periostum; tendon was wrapped with periostum. The samples were observed at 2, 4, 8, 12, 16 and 24 weeks after operation using general examination, radiological examination, optical and electron microscope tests. CT values of compound bodies were statistically analyzed. 
RESULTS AND CONCLUSION: Newly formed bone could be found at 2 weeks in compound bodies group. Rounded bony body with complete bone shell and bone marrow cells were formed in the implanted composite at 8 weeks. No degenerative changes were observed up to 24 weeks. In periosteum wrapping grains of cancellous bone group, newly formed bone and cartilage were found at 4 weeks. Mature bone trabecula was formed at 8 weeks. Rounded bony body was formed at 24 weeks. In periosteum wrapping tendon group, the composite did not form bony body until 24 weeks. Significant differences in CT value among all groups were found. Results have indicated that in compound bodies group, bony tissue forms completely, ossification occurs early, with good plasticity.