CAJ | 학술논문

目的探讨高压氧(HBO)对兔激素性股骨头坏死多孔人工假体植入后骨长入的早期影响.方法将32只4月龄新两兰白兔肌注地塞米松10 mg/kg体重/次,每周2次,共8周后分为对照组、HBO组、重组人骨形成蛋白-2组(rhBMP-2组)和HBO+rhBMP-2组.对照组和HBO组双侧股骨近端植入多孔假体,rhBMP-2组和HBO+rhBMP-2组双侧股骨近端植入胶原蛋白复合rhBMP-2多孔假体.对照组、rhBMP-2组不予HBO处理,HBO组和HBO+rhBMP-2组给予HBO处理.于术后12周处死所有动物,取右侧股骨标本用于硬组织切片,左侧标本用于生物力学推出测试.结果骨结合率:HBO+rhBMP-2组＞HBO组＞rhBMP-2组＞对照组.对照组与rhBMP-2组之间的差异无统计学意义(P＞0.05);其它各组之间差异有统计学意义(P＜0.05).孔隙内新骨形成率:HBO组＞HBO+rhBMP-2组＞对照组＞rhBMP-2组.各组之间两两比较,差异具有统计学意义(P＜0.05).推出试验结果显示,HBO组和HBO+rhBMP-2组的抗剪切强度明显高于对照组和rhBMP-2组(P＜0.05),但HBO组和HBO+rhBMP-2组间的差异无统计学意义(P＞0.05),对照组和rhBMP-2组间的差异具有统计学意义(P＜0.05).结论多孔假体植入后早期进行HBO治疗可以提高假体与骨的结合率,促进骨组织长入多孔假体中,钻铬钼合金增强假体-骨结合强度;HBO与rhBMP-2有协同作用,但rhBMP-2载体妨碍骨长入.
목적 탐토고압양(HBO)대토격소성고골두배사다공인공가체식입후골장입적조기영향.방법 장32지4월령신량란백토기주지새미송10 mg/kg체중/차,매주2차,공8주후분위대조조、HBO조、중조인골형성단백-2조(rhBMP-2조)화HBO+rhBMP-2조.대조조화HBO조쌍측고골근단식입다공가체,rhBMP-2조화HBO+rhBMP-2조쌍측고골근단식입효원단백복합rhBMP-2다공가체.대조조、rhBMP-2조불여HBO처리,HBO조화HBO+rhBMP-2조급여HBO처리.우술후12주처사소유동물,취우측고골표본용우경조직절편,좌측표본용우생물역학추출측시.결과 골결합솔:HBO+rhBMP-2조＞HBO조＞rhBMP-2조＞대조조.대조조여rhBMP-2조지간적차이무통계학의의(P＞0.05);기타각조지간차이유통계학의의(P＜0.05).공극내신골형성솔:HBO조＞HBO+rhBMP-2조＞대조조＞rhBMP-2조.각조지간량량비교,차이구유통계학의의(P＜0.05).추출시험결과현시,HBO조화HBO+rhBMP-2조적항전절강도명현고우대조조화rhBMP-2조(P＜0.05),단HBO조화HBO+rhBMP-2조간적차이무통계학의의(P＞0.05),대조조화rhBMP-2조간적차이구유통계학의의(P＜0.05).결론 다공가체식입후조기진행HBO치료가이제고가체여골적결합솔,촉진골조직장입다공가체중,찬락목합금증강가체-골결합강도;HBO여rhBMP-2유협동작용,단rhBMP-2재체방애골장입.
Objective To observe the effect of hyperbaric oxygen (HBO) therapy on bone ingrowth into porous implant in a rabbit model of avascular necrosis of femoral head induced by dexamethasone. Methods Thirty-two New Zealand rabbits were subject to intramuscular injection of dexamethasone twice a week for 8 weeks.Then,rabbits were divided into 4 groups:control group,HBO group,recombinant human bone morphogenetie protein-2 (rhBMP-2) group and HBO + rhBMP-2 group randomly.The femurs of rabbits in control group and HBO group were implanted with bare porous implants,while the rhBMP-2 group and HBO + rhBMP-2 group were implanted with porous implants of collagen compounded with rhBMP-2.Control group and rhBMP-2 group were treated without HBO;HBO group and HBO + rhBMP-2 group were treated with HBO.All rabbits were sacrificed at the 12th weeks after operation.All samples of right femurs were used for making hard tissue slices,while all samples of left femurs were used for biomechanics test. Results The oaseointegration rate:HBO + rhBMP-2 group ＞ HBO group ＞ rhBMP-2 group ＞ control group.The difference between control group and rhBMP-2 group was not statistically significant (P＞0.05).Differences among all other groups were statistically significant (P＜0.05).New bone ingrowth rate:HBO group ＞ HBO + rhBMP-2 group ＞ control group ＞ rhBMP-2 group.Differences between every two groups were statistically significant (P＜0.05).The results of pull out test showed that anti-shearing force in HBO group and HBO + rhBMP-2 group were greater than that in control group and rhBMP-2 group,the differences were statistically significant (P ＜0.05).Anti-shearing force in HBO + rhBMP-2 group was a little greater than that in HBO group,but there was no significant difference between the two groups (P ＞ 0.05).Anti-shearing force in rhBMP-2 group was significantly greater than that in control group (P＜0.05). Conclusions HBO therapy can improve osseointegration rate of bone and implant,promote new bone ingrowth into the porous implant,enhance the integration strength of bone and implant.HBO and rhBMP-2 have cooperative effect,but the carrier of rhBMP-2 can prevent bone ingrowth into implant.