摘要
背景:目前治疗长骨骨缺损的方法各异,且各自存在一定缺陷,为临床医生带来极大挑战,通过3D打印技术制备的骨移植材料有望成为治疗长骨骨缺损的一种替代方法。目的:通过体内实验研究3D打印技术制备的多孔钛合金支架修复兔桡骨缺损的能力,探讨其未来临床应用的可行性。方法:选取20只9月龄健康雄性新西兰兔(由徐州医科大学动物实验中心提供),术前使用CT行双侧前肢平扫,随机选取一侧预截断中段桡骨干为模型,经3D打印技术制备多孔钛合金支架,并用扫描电镜观察支架内部孔隙及连通性。于双侧桡骨中段制备20 mm节段性骨缺损,一侧骨缺损植入钛合金支架作为实验组,对侧不植入材料作为对照组。分别于术后第1天及12周行X射线检查,术后第12周处死实验兔取出标本,行大体观察、组织学观察,Micro-CT检测分析骨愈合情况。结果与结论:①支架内部为蜂巢状结构,孔隙间相互连通,平均孔径约为300μm,孔隙率60%-65%;②术后第12周大体观察见实验组钛支架表面有连续性骨痂通过,表面光滑;对照组桡骨断端髓腔闭塞,缺损中央为纤维组织覆盖;③X射线图像显示术后第12周实验组钛支架与两侧断端有骨性连接,对照组未修复,断端及邻近尺侧有少量新骨生成,髓腔封闭;④组织学结果及Micro-CT分析显示实验组钛合金支架孔隙内有大量新生骨长入,对照组断端闭合,由软组织填充。实验组骨体积百分比(26.35±3.89)%显著高于对照组(2.19±1.36)%(P <0.05);⑤结果提示,3D打印技术制备的多孔钛合金支架具有良好的生物相容性和骨传导性,可按需设计为特定形态,能够作为骨缺损修复的生物材料。
BACKGROUND: Various methods have been applied in the treatment of long bone defects, but each of them had some defects, making great challenge to clinicians. Three-dimensional-printed bone grafting material is expected to become an alternative method for long bone defects.OBJECTIVE: To investigate the bone regeneration of three-dimensional-printed titanium alloy scaffold in repairing large radical defects of rabbits in vivo and to explore its feasibility in clinical practice.METHODS: Twenty healthy male New Zealand White rabbits aged 9 months were included(provided by Laboratory Animal Center of Xuzhou Medical University). The rabbit bilateral forelimbs were scanned by CT preoperatively. The porous titanium alloy scaffolds were produced by three-dimensional printing technology based on the right side of middle radical shaft, which cut during the operation. The internal porosity and connectivity of the scaffold were observed by scanning electron microscope. A 20 mm radial segmental bone defect was made in the bilateral radius. Titanium alloy scaffolds were implanted in one side(experimental group), and the other side was filled with nothing(control group). On the first day and at 12 weeks postoperatively, X-ray was taken. The rabbits were sacrificed at 12 weeks postoperatively, and the forearms were harvested for gross observation and histological observation. Besides, the bone healing was evaluated by micro-CT.RESULTS AND CONCLUSION:(1) The inner structure of scaffold was alveolate, and the pores were connected to each other with an average pore size of about 300 μm and a porosity of 60% to 65%.(2) Continuous bridged callus with a smooth surface were observed on the surface of titanium alloy scaffolds at postoperative 12 weeks. However, both ends were closed in control group, and the defect area was filled with fibrous tissue.(3) In the experimental group, osseous connection between titanium alloy scaffolds and both ends was observed on X-ray images at 12 weeks postoperatively, and small amount of callus was noticed at both ends and the ulnar side of the radius in the control group,with closed marrow cavity.(4) Both micro-CT and histological analysis showed that the titanium alloy scaffolds had good ability to facilitate the osteointegration. The bone volume fraction in the experimental group(26.35%±3.89%) was significantly higher than that in the control group(2.19%±1.36%)(P < 0.05).(5) In summary, porous titanium alloy scaffold produced by three-dimensional printing technology possesses admirable biocompatibility and osteoconductivity. It can be designed as required shape and be used as the appropriate biological material for bone defect repairing.
作者
芮敏
郑欣
张云庆
姜雪峰
顾家烨
赵凤朝
郭开今
Rui Min;Zheng Xin;Zhang Yunqing;Jiang Xuefeng;Gu Jiaye;Zhao Fengchao;Guo Kaijin(Department of Orthopedics,the Affiliated Jiangyin Hospital of School of Medicine,Southeast University,Jiangyin 214400,Jiangsu Province,China;Department of Orthopedics,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 210006,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2019年第18期2789-2793,共5页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金面上项目(81672184)
项目负责人:赵凤朝
江苏省卫生计生委面上项目(H201528)
项目负责人:郭开金
江苏省科技厅社会发展重点项目(BE2015627)
项目负责人:赵凤朝~~
关键词
3D打印
多孔钛支架
骨移植材料
桡骨骨缺损
桡骨干
骨传导
骨愈合
髓腔封闭
国家自然科学基金
three-dimensional printing
porous titanium alloy scaffold
bone grafting material
radial bone defect
radial shaft
osteoconductivity
bone healing
the National Natural Science Foundation of China
