中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (20): 3625-3628.doi: 10.3969/j.issn.1673-8225.2010.20.004

• 骨组织构建 bone tissue construction • 上一篇    下一篇

自体骨膜包绕肌腱复合碱性成纤维细胞生长因子作月骨替代物

孟 钊1，田利军2，邵新中3   

  1. 1河北省儿童医院骨科，河北省石家庄市  050031； 
    2石家庄市第三医院手外科，河北省石家庄市050031；
    3河北医科大学第三医院手外科，河北省石家庄市  050051
  • 出版日期:2010-05-14 发布日期:2010-05-14
  • 作者简介:孟 钊，男，1962年生，辽宁省大连市人，汉族，1984年河北医学院毕业，硕士，硕士生导师，主任医师，教授，主要从事小儿骨科和骨组织修复与再生研究。 mz285@163.com

Autologous periosteum wrapping tendon combined with basic fibroblast growth factor as substitute for the lunate bone  

Meng Zhao1, Tian Li-jun2, Shao Xin-zhong3   

  1. 1Department of Orthopaedics, Hebei Children’s Hospital, Shijiazhuang  050031, Hebei Province, China;
    2Department of Hand Surgery, Third Hospital of Shijiazhuang, Shijiazhuang  050031, Hebei Province, China;
    3Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang  050051, Hebei Province, China
  • Online:2010-05-14 Published:2010-05-14
  • About author:Meng Zhao, Master, Master’s supervisor, Chief physician, Professor, Department of Orthopaedics, Hebei Children’s Hospital, Shijiazhuang 050031, Hebei Province, China mz285@163.com

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被引次数

1

摘要：

背景：月骨切除后以往用硅胶假体和豆状骨移位等替代，短期有一定疗效，但可发生硅胶性骨膜炎、移植骨吸收和腕骨塌陷等并发症。

目的：通过动物实验研究探讨以自体骨膜包裹肌腱复合碱性成纤维细胞生长因子(basic fibroblast growth factor，bFGF)植入物替代月骨观察其治疗月骨无菌性坏死的可行性。

方法：四五月龄健康新西兰白兔45只，以数字表法随机分为3组，骨膜包绕肌腱组、骨膜包绕肌腱与bFGF复合体组和单纯肌腱球组。于兔双膝关节内侧切取部分股四头肌腱，于胫骨近端切取骨膜备用。造模后，骨膜包绕肌腱组以骨膜生发层朝外包绕肌腱团，7-0无创尼龙线缝合成植入物后置入兔髌上囊；骨膜包绕肌腱与bFGF复合体组，骨膜生发层朝外包绕肌腱团，将1 mg碱性成纤维细胞生长因子与切取的游离肌腱混合制成植入物后置入兔髌上囊；单纯肌腱球组制作单纯游离肌腱团块，置入兔髌上囊。术后1，3，6，12，16周组织学观察骨形成，以CT机测定植入物骨密度值。

结果与结论：骨膜包绕肌腱与bFGF复合体组骨形成早于骨膜包绕肌腱组，术后3周即有新生骨细胞和软骨细胞形成，12周时已接近正常骨硬度，形成外层较厚的类似正常关节软骨层，其具有良好的几何形态、硬度和支撑作用，但骨膜包绕肌腱组同时伴有软骨化骨现象，其外层光滑呈梨白色，有类似正常的关节软骨；单纯肌腱球组无骨化现象，最终呈片状胶原，无支撑作用。骨膜包绕肌腱与bFGF复合体组骨密度值高于其他两组(P < 0.01)。提示骨膜包绕肌腱与bFGF复合体骨化作用和生物学性能明显，骨形成较强，在较短时间内形成较多骨和软骨组织，可用作月骨替代物。

关键词: 月骨, 腱, 骨膜, 碱性成纤维细胞生长因子, 肾组织工程

Abstract:

BACKGROUND: The silica gel prosthesis and os lenticulare were widely used as substitute for lunar bone, which can result in complications, such as periostitis, bone resorption as well as carpal bone collapse.

OBJECTIVE: To study the feasibility of autologous periosteum wrapping tendon combined with basic fibroblast growth factor (bFGF) as substitute for the lunate bone in treatment of aseptic necrosis.

METHODS: Totally 45 healthy New Zealand white rabbits were randomly divided into 3 groups: periostum wrapping tendon group, periostum wrapping tendon combined with bFGF group and tendon group, with 15 animals in each group. The implants were prepared by autologous periosteum of tibia wrapping partial patellar tendon combined with bFGF. The three sorts of implants were placed into articular cavity of the knee in rabbits, respectively. The changes of bone formation were examined and bone mineral density (BMD) was measured at 1, 3, 6, 12 and 16 weeks after surgery.

RESULTS AND CONCLUSION: There was some cartilage and bony forming in bFGF composite group than in the periostum wrapping tendon group at 3 weeks after operation, and reached normal bone hardness at 12 weeks. There was only hyaline degeneration and no bone formation in the control group. The bone mineral density of the periostum wrapping tendon group was greater than that of the other two groups (P < 0.01). These results demonstrated that the bFGF composite, under the induction of periosteum and bFGF factors, is of stronger bone-forming effects and can produce much cartilage and some bone in a short time. It can be used as the substitute for the lunate bone.

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