本文選題：假體植入物 + 3D打印多孔支架��； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：背景:自第一例人工關(guān)節(jié)假體植入手術(shù)始,假體植入物的穩(wěn)定性就備受關(guān)注。但假體植入物的穩(wěn)定性仍未達(dá)到令人滿意的水平,例如在全膝關(guān)節(jié)置換手術(shù)中,多種原因?qū)е碌乃拗鞴?假體植入物接觸面的不穩(wěn)定可以產(chǎn)生機(jī)械損傷、無菌性松動(dòng)、失穩(wěn)、假體周圍骨折等諸多問題,最終使假體植入物脫落、異位[1]。這使患者在不得不延長(zhǎng)住院時(shí)間、飽受身體與精神摧殘的同時(shí)還要承擔(dān)額外的經(jīng)濟(jì)負(fù)擔(dān),所以,進(jìn)一步提高術(shù)后假體植入物在宿主骨骼內(nèi)的穩(wěn)定性,變得尤為重要。隨著研究的進(jìn)展人們發(fā)現(xiàn),要想使植入物獲得良好的穩(wěn)定性,需要宿主骨與假體植入物之間存在生物形式的結(jié)合,即骨性結(jié)合;而良好的骨性結(jié)合,需要植入物具備“多孔”的特征。骨性結(jié)合觀念與“多孔”概念的提出,開辟了假體植入物設(shè)計(jì)的新領(lǐng)域,人們開始設(shè)計(jì)各種3D打印多孔支架用以研究假體植入物與宿主骨骨性結(jié)合的情況,從而提高假體植入物骨性結(jié)合的能力。在當(dāng)今骨科植入物的臨床應(yīng)用中,最常見的材料是Ti6Al4V,其生物相容性好、彈性模量低、耐腐蝕等優(yōu)點(diǎn)都備受矚目,使之成為使用最廣泛的醫(yī)用鈦合金相關(guān)材料。故本研究選用Ti6Al4V做為材料,從骨的生物學(xué)性質(zhì)與骨性結(jié)合的要求出發(fā),依托3D打印多孔支架,研究多孔結(jié)構(gòu)對(duì)假體植入物骨整合能力的影響。目的:本研究通過評(píng)價(jià)3D打印鈦合金多孔支架在體內(nèi)及體外實(shí)驗(yàn)中促進(jìn)成骨細(xì)胞分裂分化、以及骨組織長(zhǎng)入的能力,探討多孔結(jié)構(gòu)對(duì)假體植入物骨整合能力的影響。方法:在本次實(shí)驗(yàn)中,將分別檢測(cè)300um與500um兩種不同孔徑的3D打印鈦合金多孔支架。在體外實(shí)驗(yàn)部分,進(jìn)行流式細(xì)胞凋亡實(shí)驗(yàn)、細(xì)胞增殖實(shí)驗(yàn)、細(xì)胞形貌及黏附實(shí)驗(yàn)、堿性磷酸酶定量實(shí)驗(yàn);在體內(nèi)實(shí)驗(yàn)部分,我們選取適齡雄兔作為實(shí)驗(yàn)動(dòng)物,將支架通過外科手術(shù)植入兔股骨髁,飼養(yǎng)4周后取材,通過Micro-CT與組織學(xué)染色進(jìn)行骨長(zhǎng)入分析。結(jié)果:兩種不同孔徑的3D打印鈦合金多孔支架均無細(xì)胞毒性,在體外實(shí)驗(yàn)部分,兩者骨髓間充質(zhì)干細(xì)胞增殖的差距無統(tǒng)計(jì)學(xué)意義,體內(nèi)實(shí)驗(yàn)部分,可以看出300um孔徑的支架周圍有更多的新骨形成,且骨長(zhǎng)入孔徑內(nèi)程度較深。結(jié)論:支架的多孔結(jié)構(gòu)對(duì)于支架的骨整合能力至關(guān)重要,且孔徑對(duì)支架的骨整合能力存在影響,合適的支架結(jié)構(gòu)可以促進(jìn)骨組織的長(zhǎng)入,從而使假體植入物在宿主骨內(nèi)更加穩(wěn)固。在體外實(shí)驗(yàn)中300um孔徑的支架并未明顯刺激骨髓間充質(zhì)干細(xì)胞的增殖,但可以提高支架促進(jìn)成骨分化的能力,體內(nèi)實(shí)驗(yàn)中,相較500um孔徑,300um孔徑支架在周圍與內(nèi)部均形成了更多的骨組織,也證實(shí)了這一點(diǎn)。
[Abstract]:Background: the stability of prosthetic implants has attracted much attention since the first arthroplasty. However, the stability of prosthetic implants is still not satisfactory. For example, in total knee arthroplasty, the instability of the host bone-prosthesis interface caused by various causes can cause mechanical damage, aseptic loosening and instability. Fracture around the prosthesis and many other problems, the prosthesis implants fall off, ectopic [1]. Therefore, it is very important to further improve the stability of prosthesis implants in host bones. As research progresses, it has been discovered that in order for implants to achieve good stability, there needs to be a biological combination between host bone and prosthetic implants, that is, osseous bonding, and good osseous bonding. Implants are required to be "porous". The concept of osseous bonding and the concept of "porous" have opened up a new field in the design of prosthesis implants. People began to design various 3D printed porous scaffolds to study the bony bonding between prosthetic implants and the host bone. So as to improve the ability of osseous bonding of prosthesis implants. In the clinical application of orthopedic implants, the most common material is Ti6Al4V, which has many advantages such as good biocompatibility, low elastic modulus and corrosion resistance, which makes it the most widely used medical titanium alloy related material. In this study, Ti6Al4V was used as the material to study the effect of porous structure on the bone integration ability of prosthesis implants based on the requirements of the combination of bone biological properties and bone properties. Objective: to evaluate the ability of 3D printed titanium alloy porous scaffolds to promote osteoblast division and bone tissue growth in vivo and in vitro, and to explore the effect of porous structure on bone integration of prosthesis implants. Methods: in this experiment, 3D printed titanium alloy porous scaffolds with two different pore sizes, 300um and 500um, were detected. In vitro, flow cytometry, cell proliferation, cell morphology and adhesion, alkaline phosphatase quantitative assay, in vivo, we selected male rabbits as experimental animals. The stents were implanted into the femoral condyle of rabbits after 4 weeks of feeding. Bone growth was analyzed by Micro-CT and histological staining. Results: there was no cytotoxicity in the two kinds of 3D printed titanium alloy porous scaffolds with different pore sizes. There was no significant difference in the proliferation of bone marrow mesenchymal stem cells between the two scaffolds in vitro. It can be seen that there are more new bone formation around the scaffold of 300um aperture, and the bone is deep into the aperture. Conclusion: the porous structure of the scaffold is very important for the bone integration of the scaffold, and the aperture has an effect on the osteointegration of the scaffold. The suitable scaffold structure can promote the growth of bone tissue. Thus, the implant is more stable in the host bone. In vitro, 300um scaffolds did not significantly stimulate the proliferation of bone marrow mesenchymal stem cells, but increased the ability of the scaffold to promote osteogenic differentiation. This is confirmed by the formation of more bone tissue around and inside of the 300um pore scaffold than that of the 500um pore holder.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R318.08

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