一种利用羟丙基纤维素增强人工韧带移植物在骨隧道中骨整合的新策略。
A new strategy to enhance artificial ligament graft osseointegration in the bone tunnel using hydroxypropylcellulose.
机构信息
Fudan University Sports Medicine Center & Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, No. 12, Middle Urumqi Road, Shanghai, 200040, People's Republic of China.
出版信息
Int Orthop. 2013 Mar;37(3):515-21. doi: 10.1007/s00264-012-1723-2. Epub 2012 Nov 25.
PURPOSE
The aim of this study was to determine whether hydroxypropylcellulose (HPC) coating of polyethylene terephthalate (PET) artificial ligaments enhances graft osseointegration in the bone tunnel.
METHODS
Thirty New Zealand white rabbits underwent artificial ligament graft transplantation in the bilateral proximal tibia tunnels. One limb was implanted with an HPC-coated PET graft, and the contralateral limb was implanted with a non-HPC-coated PET graft as a control. The rabbits were then randomly sacrificed at weeks four and eight after surgery for biomechanical testing, histological examination, and histomorphometric and real-time polymerase chain reaction analysis.
RESULTS
At week four after surgery, there were no statistically significant differences in the load to failure or stiffness values between the experimental and control limbs (P = 0.328 and P = 0.128, respectively). At week eight after surgery, the mean load to failure and stiffness value of the experimental limbs was higher than that of the control limbs (P < 0.001 and P = 0.018, respectively). At week eight after surgery, some protruding new bone tissue from the host bone to the graft was found in the HPC-coated group, while a thick fibrous tissue band was observed at the interface between the graft and the host bone in the control group. Histomorphometric analysis showed that the graft-bone interface width in the HPC-coated group was significantly narrower than that in the control group at week eight after surgery (P < 0.001). At weeks four and eight after surgery, the mRNA expression level of bone morphogenetic protein-2 in the HPC group was higher than that in the control group (P = 0.001 and P = 0.010, respectively). The mRNA expression level of osteopontin in the HPC group was higher than that in the control group only at week four after surgery (P = 0.032).
CONCLUSIONS
Our data show that an HPC coating on the surface of PET artificial ligament grafts may induce artificial ligament graft osseointegration in the bone tunnel.
目的
本研究旨在确定羟丙基纤维素（HPC）涂覆聚对苯二甲酸乙二醇酯（PET）人工韧带是否能增强移植物在骨隧道中的骨整合。
方法
30 只新西兰白兔的双侧胫骨近端隧道接受人工韧带移植物移植。一条肢体植入 HPC 涂覆的 PET 移植物，对侧肢体植入非 HPC 涂覆的 PET 移植物作为对照。术后 4 周和 8 周时，兔子被随机处死进行生物力学测试、组织学检查、组织形态计量学和实时聚合酶链反应分析。
结果
术后 4 周时，实验组和对照组的失效负荷和刚度值均无统计学差异（P = 0.328 和 P = 0.128）。术后 8 周时，实验组的平均失效负荷和刚度值高于对照组（P < 0.001 和 P = 0.018）。术后 8 周时，HPC 涂覆组发现一些宿主骨向移植物突出的新骨组织，而对照组在移植物与宿主骨之间观察到厚的纤维组织带。组织形态计量学分析显示，术后 8 周时 HPC 涂覆组的移植物-骨界面宽度明显小于对照组（P < 0.001）。术后 4 周和 8 周时，HPC 组的骨形态发生蛋白-2 mRNA 表达水平均高于对照组（P = 0.001 和 P = 0.010）。HPC 组的骨桥蛋白 mRNA 表达水平仅在术后 4 周时高于对照组（P = 0.032）。
结论
我们的数据表明，在 PET 人工韧带移植物表面涂覆 HPC 可能会诱导骨隧道中的人工韧带移植物骨整合。
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