中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (41): 7613-7616.doi: 10.3969/j.issn.1673-8225.2010.41.004

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

自体骨膜包裹肌腱复合松质骨匀浆及重组人骨形态发生蛋白2体内成骨重建月骨

孟  钊1，胡成栋2，邵新中2   

  1. 1河北省儿童医院骨外科，河北省石家庄市 050031；2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:2010-10-08 发布日期:2010-10-08
  • 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缺损的修复与再生研究。 mz285@163.com
  • 基金资助:

    河北省自然科学基金（301384B），课题名称：外源性BMP对骨缺损/修复影响的研究。

Reconstruction of lunar bone using autologous periosteum-wrapped tendon, spongiosa homogenate and recombinant human bone morphogenetic protein-2

Meng Zhao1, Hu Cheng-dong2, Shao Xin-zhong2   

  1. 1 Department of Orthopaedics, Hebei Children’s Hospital, Shijiazhuang  050031, Hebei Province, China; 2 Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang  050051, Hebei Province, China
  • Online:2010-10-08 Published:2010-10-08
  • 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
  • Supported by:

    the Natural Science Foundation of Hebei Province, No. 301384B*

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被引次数

1

摘要：

背景：月骨摘除术后选择合适的月骨替代物填充遗留的空隙，是维护腕关节生物力学特性和良好功能的关键。
目的：探讨自体骨膜包裹肌腱复合重组人骨形态发生蛋白2(recombinant human bone morphogenetic protein-2，rhBMP-2)与松质骨匀浆植入自体关节腔后的成骨和骨化机制，以及作为月骨替代物重建月骨的可行性。
方法：按随机数字法将45只新西兰白兔分成3组：骨膜包裹肌腱组、rhBMP-2组、单纯肌腱球对照组。分别以骨膜包绕肌腱团，1 mg rhBMP-2与游离肌腱、肌腱团块置入兔髌上囊。置入后3，6和9周取材，测量定量CT骨密度值，组织切片采用苏木精-伊红染色和免疫组织化学ABC法，在光镜下观察rhBMP-2分布。
结果与结论：移植物植入后，早期骨膜包裹肌腱组rhBMP-2染色阴性，9周时阳性，之后呈阴性，表明其骨化形成主要是在骨膜成软骨作用基础上的成骨过程，而无rhBMP-2的作用；rhBMP组显示rhBMP-2分布及骨化明显强于骨膜包裹肌腱组，且随时间延长逐渐加强，9周时呈强阳性，主要分布于新生骨细胞簇和新生软骨细胞簇及周围，之后随骨细胞成熟量增多而逐渐减弱。单纯肌腱球对照组玻璃样变，最终呈胶原状rhBMP-2染色始终阴性。各组各时间点定量CT骨密度值经统计学分析，除3周时骨膜包裹肌腱组、单纯肌腱对照组间无显著性差异(P > 0.05)，其余各组间差异均有显著性意义(P < 0.01)。自体骨膜包裹肌腱复合rhBMP-2及松质骨匀浆植入物在骨rhBMP-2及松质骨匀浆中rhBMP-2的诱导作用下可形成大量骨和软骨，有较强支撑作用，为其用作月骨替代物提供实验依据。

关键词: 月骨, 骨膜, 重组人骨形态发生蛋白2, 松质骨匀浆, 修复重建

Abstract:

BACKGROUND: Selection of optimal substitute to fill the gaps following lunar bone enucleation plays a key role in maintaining biomechanical properties and good wrist joint function.
OBJECTIVE: To study bone-forming mechanism of transplantation autologous periosteum-wrapped tendon, spongiosa homogenate and recombinant human bone morphogenetic protein-2 (rhBMP-2) in joint cavity, and to explore the possibility of the compound as a substitute for the lunar bone.  
METHODS: Forty-five New Zealand white rabbits were randomly divided into three groups: periosteum group, rhBMP-2 group and control group. The three sorts of implants were placed into articular cavity of the knee respectively. The changes of bone formation and rhBMP-2 distribution of the implants were examined under optical microscope with hematoxylin-eosin staining and immunohistochemical staining and measured by CT at 3, 6 and 9 weeks after operation. 
RESULTS AND CONCLUSION: The result of rhBMP-2 staining was negative after 3 weeks and positive in new cartilage cells after 9 weeks in periosteum group. The strong positive rhBMP-2 staining was observed in the composite group at 9 weeks, which mainly distributed in new bone cells and cartilage cells. And negative rhBMP-2 staining was observed every stage in control group. The quantitative CT bone mineral density values of 3 implants were analyzed, the difference was significant between the groups (P < 0.01), except that between periosteum group and control group at 3 weeks (P > 0.05). The above results demonstrated that the compound of autologous periosteum-wrapped tendon and spongiosa homogenate can produce bone and cartilage massively under the induction of periosteum and bone forming factors, such as rhBMP-2 in spongiosa homogenate and the compound can be considered as a preferred substitute to reconstruct lunate bone.

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