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基于纳米羟磷灰石的自体软骨移植治疗距骨骨软骨损伤的临床研究。

Clinical Study of Autologous Cartilage Transplantation Based on Nano-Hydroxyapatite in the Treatment of Talar Osteochondral Injury.

机构信息

Department of Orthopaedics, The Seventh People's Hospital of Zibo, Zibo City, 255000, Shandong Province, China.

Department of Orthopaedics, Jimo District Hospital of Traditional Chinese Medicine, Jimo, Qingdao City, 26200, Shandong Province, China.

出版信息

J Nanosci Nanotechnol. 2021 Feb 1;21(2):1250-1258. doi: 10.1166/jnn.2021.18634.

Abstract

Talus osteochondral damage is one of the common symptoms of chronic ankle pain in people's lives. The cartilage regeneration and self-repair ability are extremely limited, the joint cartilage lesions are often accompanied by the lesions of the subchondral bone, and the subchondral bone lesions can affect the metabolism of the cartilage above it, which brings certain difficulties to clinical treatment. Traditional methods of treating cartilage damage include microfractures and drilling. Due to large trauma, inconsistent clinical efficacy reports, poor tissue repair results, and limited donor sources, etc., the application of traditional treatment methods in the clinic has been largely limited. Therefore, finding an ideal treatment method for bone injury has been a hot spot in clinical research in orthopedics. Studies have shown that autologous cartilage transplantation via nano-hydroxyapatite has become a new treatment model, providing new ideas for clinical treatment of talar osteochondral damage. Nano-hydroxyapatite and its composites have good histocompatibility, biological activity, and bone conductivity. They are an ideal bone defect repair material, and have been initially applied in clinical practice. The preparation of nano-hydroxyapatite, its biological characteristics and the repairing effect on the composite defect of osteochondral bone were studied experimentally, and its feasibility for repairing osteochondral damage was discussed. In this paper, the unique structure and properties of natural cartilage layers are studied. In combination with bionics theory and methods, nano-hydroxyapatite micro-particle composite samples are prepared by the gel method, and the bone-forming properties of nano-composites are measured by drug release experiments. To establish a model of infectious bone injury in New Zealand white rabbits, and nano-hydroxyapatite composites were implanted into local lesions of New Zealand white rabbit models by autologous cartilage transplantation, and evaluated by imaging, blood biochemistry, histology, infection control and bone repair. The experimental results show that using the unique physical and chemical and biological properties of nano-hydroxyapatite materials. It is innovatively introduced into the treatment of talar osteochondral defects caused by open fractures. It has been proven and experiments that nano-hydroxyapatite materials can be used. As an ideal tissue engineering scaffold for the treatment of talar osteochondral defects, this provides a new way to solve clinical orthopedic problems using new nanomaterials.

摘要

距骨骨软骨损伤是人们生活中慢性踝关节疼痛的常见症状之一。软骨的再生和自我修复能力极其有限,关节软骨损伤常伴有软骨下骨的损伤,软骨下骨的损伤会影响其上方软骨的代谢,给临床治疗带来一定的困难。传统的治疗软骨损伤的方法包括微骨折和钻孔。由于创伤大、临床疗效报道不一致、组织修复效果差、供体来源有限等,传统治疗方法在临床上的应用受到了很大的限制。因此,寻找理想的骨损伤治疗方法一直是骨科临床研究的热点。研究表明,纳米羟基磷灰石自体软骨移植已成为一种新的治疗模式,为距骨骨软骨损伤的临床治疗提供了新的思路。纳米羟基磷灰石及其复合材料具有良好的组织相容性、生物活性和骨传导性,是一种理想的骨缺损修复材料,已初步应用于临床实践。本实验对纳米羟基磷灰石的制备、生物学特性及其对骨软骨复合缺损的修复效果进行了研究,探讨了其修复骨软骨损伤的可行性。本文研究了天然软骨层的独特结构和性能,结合仿生学理论和方法,采用凝胶法制备纳米羟基磷灰石微颗粒复合材料,通过药物释放实验测量纳米复合材料的成骨性能。建立新西兰白兔感染性骨损伤模型,通过自体软骨移植将纳米羟基磷灰石复合材料植入新西兰白兔模型局部病变部位,通过影像学、血液生化、组织学、感染控制和骨修复进行评价。实验结果表明,利用纳米羟基磷灰石材料独特的物理化学和生物学特性,将其创新性地引入开放性骨折所致距骨骨软骨缺损的治疗中,经实验证明纳米羟基磷灰石材料是可用的,作为治疗距骨骨软骨缺损的理想组织工程支架,为利用新型纳米材料解决临床骨科问题提供了新途径。

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