CAJ | 학술논문

目的通过股骨内置入聚乙烯颗粒及钛钉,建立大鼠假体周围骨溶解模型,为防治假体周围骨溶解提供实验基础.方法取30只雄性SD大鼠,按随机数字表法分成模型组、假手术组及空白对照组3组.模型组取膝关节直切口,经髌旁内侧入路充分暴露膝关节,经股骨髁间窝钻孔(直径1.5 mm、深度1.5 cm),置入含10 mg/mL聚乙烯颗粒的混合物200 μL,然后置入钛棒(直径1.2 mm、长1.5 cm),骨蜡封闭后逐层缝合.假手术组的前处理同模型组,钻孔后即骨蜡封闭逐层缝合,无颗粒及钛棒置入.空白对照组不做任何处理.常规饲养7周后处死大鼠,取血清及右侧股骨新鲜标本,检测抗酒石酸酸性磷酸酶5b、钙、磷、碱性磷酸酶,血清水平、钼靶摄片、骨组织病理切片及HE染色,观察造模情况.结果模型组血清Trap-5b水平明显高于其他两组,而碱性磷酸酶水平则明显低于其他两组,差异均有统计学意义(P＜0.05).模型组股骨在钛钉周围有衬性骨溶解征象.组织病理学示:模型组钛棒周围骨小梁稀疏明显,骨小梁排列紊乱,局部断裂缺损,出现明显骨溶解征象.假手术组及空白对照组则为正常影像学及病理学表象.结论假体周围骨溶解模型具有可行性,可为人工关节无菌性松动提供实验基础.
목적 통과고골내치입취을희과립급태정,건립대서가체주위골용해모형,위방치가체주위골용해제공실험기출.방법 취30지웅성SD대서,안수궤수자표법분성모형조、가수술조급공백대조조3조.모형조취슬관절직절구,경빈방내측입로충분폭로슬관절,경고골과간와찬공(직경1.5 mm、심도1.5 cm),치입함10 mg/mL취을희과립적혼합물200 μL,연후치입태봉(직경1.2 mm、장1.5 cm),골사봉폐후축층봉합.가수술조적전처리동모형조,찬공후즉골사봉폐축층봉합,무과립급태봉치입.공백대조조불주임하처리.상규사양7주후처사대서,취혈청급우측고골신선표본,검측항주석산산성린산매5b、개、린、감성린산매,혈청수평、목파섭편、골조직병리절편급HE염색,관찰조모정황.결과 모형조혈청Trap-5b수평명현고우기타량조,이감성린산매수평칙명현저우기타량조,차이균유통계학의의(P＜0.05).모형조고골재태정주위유츤성골용해정상.조직병이학시:모형조태봉주위골소량희소명현,골소량배렬문란,국부단렬결손,출현명현골용해정상.가수술조급공백대조조칙위정상영상학급병이학표상.결론 가체주위골용해모형구유가행성,가위인공관절무균성송동제공실험기출.
Objective To develop a rat model of bone dissolution for research into prevention and control of osteolysis around a prosthesis.Methods Thirty male SD rats were randomized into an experimental group,a sham operation group and a control group.In the experimental group,the knee joint was exposed via a medial para-patellar incision.A hole of 1.5 nun in diameter and 1.5 cm in length was drilled from the femoral intercondylar notch through the femoral medullary canal.Gelatin gel containing polyethylene particles was injected into the hole at a dose of 200 μL/rat followed by insertion of a titanium rod (1.2 mm in diameter and 1.5 cm in length).The excessive gelatin extruded out of the hole was removed before the hole was covered with bone wax.In the sham operation group,the wound was sutured with nothing inserted after the hole was drilled and covered with bone wax.No measures were taken in the control group.All the rats were euthanized at 7 weeks after surgery to obtain samples of the serum and right femur.The serum levels of Trap-5b(tartrate-resistant acid phosphatase 5b),Ca(calcium),P(Phosphorus) and ALP(alkaline phosphatase) were observed and radiological and histopathological analyses were conducted.Results X-ray showed phenomenon of osteolysis around the titanium rod in the femur in the experimental group.Histopathological observation also showed obvious bone resorption around the rod in the experimental group.The other 2 groups showed normal radiological and histopathological observations.The serum level of Trap5b was significantly higher and the ALP level was significantly lower in the experimental group than in the other 2 groups ( P ＜ 0.05).Conclusion Since the rat model can result in osteolysis around a prosthesis,it can be used for further research on sterile loosening of a joint prosthesis.