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[生物玻璃与壳聚糖改性多孔生物活性骨水泥的体内实验]

[In vivo experiment of porous bioactive bone cement modified by bioglass and chitosan].

作者信息

Li Yang, Lei Wei, Wang Zheng, Zhang Yi, Niu Erlong, Yu Long, Wu Jianwei, Zang Yuan, Liu Zhichen, Wu Zixiang

机构信息

Department of Orthopedics, Xijing Hospital, the Fourth Military Medical University, Xi'an Shaanxi, 710032, P.R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Mar;27(3):320-5.

Abstract

OBJECTIVE

To investigate the biomechanical properties of porous bioactive bone cement (PBC) in vivo and to observe the degradation of PBC and new bone formation histologically.

METHODS

According to the weight percentage (W/W, %) of polymethylmethacrylate (PMMA) to bioglass to chitosan, 3 kinds of PBS powders were obtained: PBC I (50: 40:10), PBC II (40:50:10), and PBC III (30:60:10). The bilateral femoral condylar defect model (4 mm in diameter and 10 mm in depth) was established in 32 10-month-old New Zealand white rabbits (male or female, weighing 4.0-4.5 kg), which were randomly divided into 4 groups (n = 8); pure PMMA (group A), PBC I (group B), PBC II (group C), and PBC III (group D) were implanted in the bilateral femoral condylar defects, respectively. Gross observation were done after operation. X-ray films were taken after 1 week. At 3 and 6 months after operation, the bone cement specimens were harvested for mechanical test and histological examination. Four kinds of unplanted cement were also used for biomechanical test as control.

RESULTS

All rabbits survived to the end of experiment. The X-ray films revealed the location of bone cement was at the right position after 1 week. Before implantation, at 3 months and 6 months after operation, the compressive strength and elastic modulus of groups C and D decreased significantly when compared with those of group A (P < 0.05), but no significant difference was found between groups C and D (P > 0.05); the compressive strength at each time point and elastic modulus at 3 and 6 months of group B decreased significantly when compared with those of group A (P < 0.05). Before implantation and at 3 months after operation, the compressive strength and elastic modulus of groups C and D decreased significantly when compared with those of group B (P < 0.05); at 6 months after operation, the compressive strength of group C and the elastic modulus of group D were significantly lower than those of group B (P < 0.05). The compressive strength and elastic modulus at 3 and 6 months after operation significantly decreased when compared with those before implantation in groups B, C, and D (P < 0.05), but no significant difference was found in group A (P < 0.05). At 3 months after operation, histological observation showed that a fibrous tissue layer formed between the PMMA cement and bone in group A, while chitosan particles degraded with different levels in groups B, C, and D, especially in group D. At 6 months after operation, chitosan particles partly degraded in groups B, C, and D with an amount of new bone ingrowth, and groups C and D was better than group B in bone growth; group A had no obvious change. Quantitative analysis results showed that the bone tissue percentage was gradually increased in the group A to group D, and the bone tissue percentage at 6 months after operation was significantly higher than that at 3 months within the group.

CONCLUSION

According to the weight percentage (W/W, %) of PMMA to bioglass to chitosan, PBCs made by the composition of 40:50:10 and 30:60:10 have better biocompatibility and biomechanical properties than PMMA cement, it may reduce the fracture risk of the adjacent vertebrae after vertebroplasty.

摘要

目的

研究多孔生物活性骨水泥(PBC)在体内的生物力学性能,并从组织学角度观察PBC的降解及新骨形成情况。

方法

根据聚甲基丙烯酸甲酯(PMMA)、生物玻璃和壳聚糖的重量百分比(W/W,%),制备3种PBC粉末:PBC I(50:40:10)、PBC II(40:50:10)和PBC III(30:60:10)。选取32只10月龄新西兰白兔(雌雄不限,体重4.0 - 4.5 kg)建立双侧股骨髁缺损模型(直径4 mm,深度10 mm),随机分为4组(n = 8);分别将纯PMMA(A组)、PBC I(B组)、PBC II(C组)和PBC III(D组)植入双侧股骨髁缺损处。术后进行大体观察。术后1周拍摄X线片。术后3个月和6个月,取出骨水泥标本进行力学测试和组织学检查。另外取4种未植入的骨水泥作为对照进行生物力学测试。

结果

所有兔子均存活至实验结束。术后1周X线片显示骨水泥位置正确。术前、术后3个月和6个月,C组和D组的抗压强度和弹性模量与A组相比显著降低(P < 0.05),但C组和D组之间无显著差异(P > 0.05);B组在各时间点的抗压强度以及术后3个月和6个月的弹性模量与A组相比显著降低(P < 0.05)。术前及术后3个月,C组和D组的抗压强度和弹性模量与B组相比显著降低(P < 0.05);术后6个月,C组的抗压强度和D组的弹性模量显著低于B组(P < 0.05)。术后3个月和6个月,B组、C组和D组的抗压强度和弹性模量与植入前相比显著降低(P < 0.05),而A组无显著差异(P < 0.05)。术后3个月组织学观察显示,A组PMMA骨水泥与骨之间形成纤维组织层,而B组、C组和D组壳聚糖颗粒有不同程度降解,尤其D组。术后6个月,B组、C组和D组壳聚糖颗粒部分降解,有一定量新骨长入,C组和D组骨生长情况优于B组;A组无明显变化。定量分析结果显示,A组至D组骨组织百分比逐渐升高,且组内术后6个月骨组织百分比显著高于术后3个月。

结论

根据PMMA、生物玻璃和壳聚糖的重量百分比(W/W,%),由40:50:10和30:60:10组成的PBC比PMMA骨水泥具有更好的生物相容性和生物力学性能,可能降低椎体成形术后相邻椎体骨折风险。

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