BACKGROUND: Treatment of large bone defects is an important problem faced by orthopedic physicians. Allogeneic bone transplantation is a classic method, but it has many restrictions. The membrane guided bone regeneration technique has become an important method for the research nowadays.OBJECTIVE:To compare the effects of self-made high strength biodegradable nano-hydroxyapatite/multi(amino acid) copolymer (n-HA/MACP) guided bone regeneration membrane tube and allograft bone graft segment in the repair of large segmental bone defect in goats. METHODS: The model of 30 mm large segment bone defect in the middle section of the femur in 32 adult goats was established. Experimental group used self-made n-HA/MACP tube to bridge defects following bone plate fixation. The control group was treated with allograft bone graft bone segments combined with plate fixation. The animals were sacrificed at 4, 8, 12 and 16 weeks after operation, and the bone callus growth was observed in the specimens. The X-ray and histological observations were performed at the same time. Biomechanical measurement of plate fixation of allograft cortical bone segment was done at 12 and 16 weeks after operation. RESULTS AND CONCLUSION: (1) After 4 to 16 weeks, gross and pathological results showed fibrous callus growth inside and outside of the membrane tube, and the fibrous callus gradually hardened into a bony callus. Additionally, the callus was larger in the experimental group than in the control group. X-ray films showed significantly increased lateral callus density in the experimental group as compared with the control group. (2) Maximum bending strength was significantly higher in the experimental group than in the control group at 16 weeks (P < 0.05). Overall, the n-HA/MACP membrane tube used for bridging large segment bone defects in goats can obtain similar repair effects to the allograft cortical bone, and further achieve the better mechanical strength of the new bone segment than the allograft bone.%背景:大段骨缺损的修复问题仍然是骨科医师面对的重要难题,同种异体骨移植是经典的治疗方案,但存在诸多限制,引导性骨再生技术的骨重建再生效果成为研究该课题的重要思路和方法.目的:比较自制高强度可降解纳米羟基磷灰石/多元氨基酸共聚复合材料引导性骨再生膜管与同种异体皮质骨段修复山羊股骨大段骨缺损的效果.方法:建立32只成年山羊股骨中段30 mm大段骨缺损模型.实验组采用自制纳米羟基磷灰石/多氨基酸共聚复合材料膜管桥接骨缺损并采用接骨板固定,对照组采用同种异体皮质骨段桥接并结合接骨板固定.于术后4,8,12,16周处死动物,观察大体标本骨痂生长情况,并行X射线、组织学观察;术后12,16周对钢板固定皮质骨段行生物力学测定.结果与结论:①术后4-16周,2组大体标本及病理结果均提示膜管内外侧有纤维骨痂生长,并逐渐硬化成为骨性骨痂,但实验组骨痂生长更多;X射线片见纳米羟基磷灰石/多氨基酸共聚复合物膜管外侧骨痂密度增高较同种异体骨管更为明显;②16周时实验组最大抗弯曲强度显著高于对照组,差异有显著性意义(P<0.05);③综上,纳米羟基磷灰石/多元氨基酸共聚复合材料膜管桥接山羊大段骨缺损可取得与同种异体皮质骨段移植相仿的修复效果,且愈合后新生骨段的力学强度优于同种异体移植骨段.
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