Wen Chun-Yi, Qin Ling, Lee Kwong-Man, Chan Kai-Ming
Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
The Hong Kong Jockey Club Sports Medicine and Health Sciences Centre, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
J Biomed Mater Res B Appl Biomater. 2009 May;89(2):466-474. doi: 10.1002/jbm.b.31236.
This study was designed to investigate the osteoconductivity and bioresorption of brushite calcium phosphate cement (CPC) in bone-tendon interface healing after anterior cruciate ligament (ACL) reconstruction. Surgical reconstruction using grafted tendon in bone tunnel was performed bilaterally in 28 skeletal mature rabbits. Brushite CPC was implanted between grafted tendon and bone tunnel of one limb with the contralateral one as the control. A batch of 14 rabbits was sacrificed at 6 and 12 weeks, respectively, after surgery. At each time point, six rabbits were used for micro-CT and subsequent histological examinations, whereas the remaining eight rabbits were used for pull-out testing. The components of brushite CPC-dicalcium phosphate dihydrate matrix degraded rapidly with beta-tricalcium phosphate granules left for guiding new bone formation. Brushite CPC augmented the peri-tendon bone volume and promoted bone growth into the healing interface. The ultimate strength and stiffness of the graft-tunnel complexes on experimental side was higher than that of the control by 117% and 102%, respectively, at 6 weeks postoperatively (p < 0.05 for both). The use of brushite CPC caused a paradigm shift in failure mode from intra-tunnel to intra-articular portion at 12 weeks postoperatively (p = 0.013). Brushite CPC significantly enhanced the bone-tendon integration after ACL reconstruction, which provided a scientific basis for clinical application.
本研究旨在探讨透钙磷石磷酸钙骨水泥（CPC）在前交叉韧带（ACL）重建术后骨-肌腱界面愈合中的骨传导性和生物吸收性。对28只骨骼成熟的兔子双侧进行使用骨隧道内移植肌腱的手术重建。将透钙磷石CPC植入一侧肢体的移植肌腱与骨隧道之间，对侧作为对照。术后分别在6周和12周处死一批14只兔子。在每个时间点，6只兔子用于显微CT及随后的组织学检查，其余8只兔子用于拔出试验。透钙磷石CPC - 二水磷酸二钙基质成分迅速降解，留下β - 磷酸三钙颗粒以引导新骨形成。透钙磷石CPC增加了肌腱周围骨体积，并促进骨向愈合界面生长。术后6周时，实验侧移植物 - 隧道复合体的极限强度和刚度分别比对照侧高117%和102%（两者p < 0.05）。术后12周时，使用透钙磷石CPC导致失效模式从隧道内部分转变为关节内部分（p = 0.013）。透钙磷石CPC显著增强了ACL重建术后的骨 - 肌腱整合，为临床应用提供了科学依据。
