摘要
目的探讨骨形态发生蛋白(BMP)诱导肌腱移植物成骨化对肌腱-骨隧道愈合(简称腱-骨)的影响。方法取健康成年新西兰兔26只建立腱-骨愈合模型,实验组采用BMP处理移植物及腱-骨界面,对照组仅采用生理盐水处理。术后12周时研究对象进行大体解剖观察、组织形态学检测及CT扫描,采用t检验比较各组之间腱-骨愈合情况。结果 12周时,实验组移植肌腱质地变硬,与宿主骨组织紧密连接、局部相互融合。苏木精-伊红染色(HE)和Masson染色显示实验组腱-骨界面以纤维软骨及Sharpey’s纤维连接为主。肌腱内部及界面之间均可见新生骨组织形成,部分区域新生骨与宿主骨组织形成骨性连接。而对照组移植物肌腱形态结构无变化,腱-骨界面间隙明显,以纤维结缔组织连接为主、未见新生骨形成。组织学评分结果显示BMP处理组腱-骨愈合更加成熟(6.6±0.8)vs(2.7±0.7),(t=13.361,P<0.01)。CT扫描检测结果显示实验组肌腱移植区域骨密度(191±17),明显高于对照组(11±4)(t=31.591,P<0.01),提示肌腱移植区域发生成骨化。结论BMP能够诱导肌腱移植物成骨化并促进腱-骨愈合。
Objective To study bone morphogenetic protein（ BMP）-induced osteogenesis of tendon graft and its effect on the healing of tendon-bone interface. Methods The model of tendon-bone healing was established in twenty-six adult New Zealand rabbits. Both tendon graft and tendon-bone interface were simultaneously treated with BMP in the experimental group,and the control group was only treated with normal saline. Twelve weeks after treatment,the animals were sacrificed and studied by gross anatomy,histomorphology and computer tomography（ CT）. The healing of tendon-bone interface in different groups was analysed by Student’s t test correspondingly. Results Twelve weeks after treatment,the tendon graft within bone tunnel of experimental group became hard in texture and connected close to adjacent host bone.Especially,the calcified tendon graft integrated with host bone to some extent. With hematoxylin-eosin（ HE）and Masson staining,it was found that the tendon-bone interface mainly consisted of fibrocartilage and Sharpey’s fibers in the BMP-treated group. New bone formed in both tendon graft and tunnel gap. In some place,the newly-formed trabecula connected closed to the host bone. However,there was mainly connective tissue present in the gap of control group. According to the histological scoring system,the BMP-treated group got higher scores（ 6. 6 ± 0. 8） as compared to that of control group（ 2. 7 ± 0. 7）,the difference was statistical significant（ t = 13. 361,P 〈 0. 01）. With CT scanning,the higher signal of density was present in the bone tunnel of BMP-treated group（ 191 ± 17） than that of control group（ 11 ± 4）,which indicated the osteogenesis of tendon graft within the host tunnel（ t = 31. 591,P 〈 0. 01）. Conclusion BMP is able to induce osteogenesis of tendon graft and this further enhances the healing of tendon-bone interface.
作者
吴波
罗永忠
梁晓松
李乃义
周慧
孙磊
Wu Bo;Luo Yongzhong;Liang Xiaosong;Li Naiyi;Zhou Hui;Sun Lei(Department of Orthopaedics 88th hospital of PLA,Tai＇ an 271000,China)
出处
《中华关节外科杂志（电子版）》
CAS
2018年第3期363-367,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
全军青年培育项目(14QNP027)
山东省自然科学基金(ZR2014HQ010)
中国博士后科学基金(2013M532177)
