本文選題：多孔鈦合金 + β-磷酸三鈣��； 參考：《第四軍醫(yī)大學(xué)》2012年碩士論文

【摘要】：背景： 感染，創(chuàng)傷以及骨腫瘤切除常常導(dǎo)致較大的骨缺損，其修復(fù)一直是臨床上所面臨的難題。金屬骨替代材料，如鉭金屬和鈦金屬及其合金，具有優(yōu)良的機(jī)械強(qiáng)度，為臨床醫(yī)生所青睞。然而，實體金屬材料其彈性模量遠(yuǎn)高于自然骨，植入體內(nèi)后容易產(chǎn)生應(yīng)力遮擋效應(yīng)，使得植入物松動，脫落，影響植入物的穩(wěn)定性。資料表明，金屬材料的結(jié)構(gòu)特性能明顯影響新骨長入的速度，其中多孔材料的孔徑大小和孔隙率是極其重要的兩個影響因素。對金屬植入材料進(jìn)行多孔設(shè)計，不僅保留了金屬材料優(yōu)良的機(jī)械強(qiáng)度，耐腐蝕性，還可以通過調(diào)整孔徑大小和孔隙率來改變材料的彈性模量，使其與自然骨相匹配。研究顯示，具有孔隙結(jié)構(gòu)的植入材料能促進(jìn)營養(yǎng)物質(zhì)和代謝產(chǎn)物的運(yùn)輸，促進(jìn)細(xì)胞的黏附，引導(dǎo)新骨的長入，因此，多孔金屬骨植入物材料越來越多地被應(yīng)用于臨床，已達(dá)到良好的材料-骨界面生物穩(wěn)定和骨修復(fù)重建的作用。以往的研究多針對小孔徑多孔材料（＜1.0mm），大孔徑多孔材料對新骨形成的影響研究尚不充分，是否多孔金屬材料的孔徑越大，骨長入的效果越好，多大的孔徑參數(shù)對骨長入最為有利，上述問題成為本研究的重點。 實驗一多孔鈦合金孔徑大小對新骨形成的影響 目的： 觀察不同孔徑的大孔多孔鈦合金植入骨缺損區(qū)后新骨長入情況，評價骨缺損的修復(fù)重建效果 方法： 通過電子束熔融（EBM）技術(shù)制備1.0mm，2.0mm，3.0mm三種不同孔徑，孔徑規(guī)則，孔隙率依次為73%，79%，86%的多孔鈦合金材料，規(guī)格為1.0cm×1.0cm×1.0cm正方體。取18只家犬，隨機(jī)分為1.0mm，2.0mm，3.0mm孔徑材料組，每組6只。制備雙側(cè)股骨外側(cè)髁缺損模型，缺損區(qū)域大小同材料大小，隨后植入各孔徑組材料，分別于術(shù)后4周，8周，12周行大體標(biāo)本觀察，X線片，組織形態(tài)檢測，Micro-CT掃描，觀察三組不同孔徑材料與周圍骨的整合情況及孔隙中的新骨長入情況。 結(jié)果： 組織學(xué)觀察發(fā)現(xiàn)，1.0mm孔徑組材料隨時間延長孔徑中心及材料周圍新生骨明顯增多；2.0mm孔徑組材料8周和4周相比新生骨面積比顯著增加，12周與8周相比無明顯增多；3.0mm孔徑材料組隨時間延長新生骨面積比增加不明顯。術(shù)后12周，大體標(biāo)本觀察和X線片觀察顯示三組材料均與周圍骨緊密連接，其中1.0mm孔徑組材料中心成骨明顯，2.0mm孔徑組和3.0mm孔徑組材料中心多為纖維組織充斥。組織學(xué)觀察顯示，12周時1.0mm孔徑組材料周圍被骨質(zhì)緊密包繞，孔中有較多新生骨形成，且孔壁四周有大量纖維母細(xì)胞和軟骨細(xì)胞形成，新骨面積百分比為20.11%±2.74%；2.0mm孔徑組和3.0mm孔徑組材料周圍雖然有骨質(zhì)包繞，但中心空洞，骨質(zhì)形成較少，新骨面積百分比分別為10.45%±1.83%，9.26%±1.00%。1.0mm孔徑組材料在各時間點新生骨面積百分比均明顯高于其余兩組，P0.01,差異具有統(tǒng)計學(xué)意義。2.0mm孔徑組和3.0mm孔徑組材料相比，P0.05，無顯著統(tǒng)計學(xué)差異。Micro-CT掃描結(jié)果顯示，12周時1.0mm孔徑組材料中心新生骨較多，骨密度明顯高于其余兩組，材料周圍亦有骨質(zhì)緊密包繞。2.0mm和3.0mm孔徑組材料周圍雖有骨質(zhì)包繞，但中心空洞，基本無骨質(zhì)形成。結(jié)果與組織學(xué)結(jié)果相符。 結(jié)論： 多孔鈦合金材料的骨長入受材料孔徑大小的影響，對于大孔結(jié)構(gòu)，孔徑超出一定范圍將影響新骨長入；對材料孔徑進(jìn)行適當(dāng)?shù)脑O(shè)計將更有利于材料的骨傳導(dǎo)作用。 實驗二不同孔徑多孔鈦合金/β-磷酸三鈣復(fù)合材料修復(fù)骨缺損的實驗研究 目的： 評價不同孔徑多孔鈦合金/β-磷酸三鈣復(fù)合材料對犬長骨骨缺損修復(fù)的影響。 方法： 采用電子束熔融（EBM）技術(shù)制備兩種不同孔徑（孔徑分別為2.0mm，3.0mm）的多孔鈦合金材料，孔徑規(guī)則，，規(guī)格為1.0cm×1.0cm×1.0cm正方體，將其孔隙用β-磷酸三鈣（β-TCP）燒結(jié)填充。取8只成年家犬，隨機(jī)分為兩組，每組4只。制備家犬雙側(cè)股骨外側(cè)髁缺損模型，缺損區(qū)域大小同材料大小，將兩種孔徑的復(fù)合材料分別植入股骨外側(cè)髁缺損區(qū)，左側(cè)為2.0mm組，右側(cè)為3.0mm組。3個月后取材，行大體觀察，X線觀察，組織學(xué)觀察了解兩種孔徑的復(fù)合材料與周圍骨的整合情況及新骨長入情況。 結(jié)果： X線片顯示3個月時兩組多孔復(fù)合材料均與周圍骨連接，都有不同程度的成骨，成骨由周圍向中心生長。組織學(xué)觀察顯示3個月時2.0mm孔徑組材料與周圍骨連接尚存在間隙，骨小梁排列稀疏。3.0mm孔徑組材料周圍及中心有大量新生骨組織形成，骨小梁排列緊密，數(shù)量明顯多于2.0mm孔徑組材料，周圍骨與材料結(jié)合緊密。2.0mm孔徑組材料的新骨面積百分比（14.65%1.12%）明顯少于3.0mm孔徑組（25.95%1.11%），兩組差異有統(tǒng)計學(xué)意義，P0.01。結(jié)論： 多孔鈦合金/β-磷酸三鈣復(fù)合材料的孔徑大小影響新骨的長入；人工骨與多孔鈦合金材料復(fù)合后將改變原有孔徑單純多孔金屬材料的骨長入行為。
[Abstract]:Background:
Infection, trauma, and bone tumor resection often lead to large bone defects, and their repair has been a clinical problem. Metal bone substitute materials such as tantalum metal and titanium metal and their alloys have excellent mechanical strength and are favored by clinicians. However, the elastic modulus of solid metal materials is much higher than that of the natural bone and is implanted in the body. It is easy to produce the stress shielding effect, which makes the implants loose, exfoliated, and affects the stability of the implants. Data show that the structural properties of metal materials can significantly affect the speed of the new bone, in which the pore size and porosity of the porous material are two important factors. The porous design for metal implants is not only retained. The excellent mechanical strength and corrosion resistance of metal materials can also be adjusted by adjusting the size and porosity of the pores to match the elastic modulus of the material to match the natural bone. The study shows that the porous material can promote the transport of nutrients and metabolites, promote cell adhesion, and guide the growth of new bone, therefore, Porous metal implant materials have been used more and more in clinical practice and have achieved good material - bone interface biological stability and bone repair and reconstruction. Previous studies have focused on small pore porous materials (< 1.0mm). The effect of large aperture porous materials on the formation of new bone is not sufficient, and the larger the pore size of porous metal is, The better the effect of bone ingrowth, the larger the pore size parameters are most favorable for bone ingrowth.
Effect of pore size on the formation of new bone in porous titanium alloy
Objective:
To observe the growth of new bone after implantation of macroporous porous titanium alloy with different diameters and evaluate the effect of bone defect reconstruction.
Method:
Through electron beam melting (EBM) technique, three kinds of porous titanium alloy materials with different pore sizes and pore sizes of 73%, 79% and 86% were prepared by electron beam melting (EBM). The specifications were 1.0cm x 1.0cm x 1.0cm square. 18 dogs were selected to be randomly divided into 1.0mm, 2.0mm, 3.0mm aperture material group, 6 of each group, and the defect area was prepared by bilateral femoral lateral condyle defect. The size of the area was the same as the size of the material, then the materials were implanted in each aperture group. The gross specimens were observed at 4 weeks, 8 weeks and 12 weeks after the operation. The X-ray film, tissue morphology and Micro-CT scan were used to observe the integration of the three groups of different pore sizes and the surrounding bone and the condition of the new bone in the pores.
Result:
Histological observation showed that the size of the 1.0mm pore group increased significantly with time and the new bone around the material increased significantly over time, and the ratio of new bone area in the 2.0mm aperture group was significantly increased in 8 weeks and 4 weeks, and there was no significant increase in the 12 weeks compared with 8 weeks. The specimen observation and X-ray observation showed that the three groups were closely connected with the surrounding bone, of which the 1.0mm aperture group material center was osteogenic, and the 2.0mm aperture group and the 3.0mm aperture group were mostly fibrous tissue. The histological observation showed that at the time of 12 weeks, the pores of the 1.0mm pore group were tightly wrapped around the bone, and there were more new bone formation in the hole. A large number of fibroblasts and chondrocytes were formed around the wall of the hole, the percentage of the new bone area was 20.11% + 2.74%, while the 2.0mm aperture group and the 3.0mm aperture group were surrounded by bone, but the central cavity, the bone formation was less, the percentage of the new bone area was 10.45% + 1.83%, and the 9.26% + 1.00%.1.0mm pore group materials were new bone at all time points. The percentage of area was significantly higher than that of the other two groups, P0.01. The difference was statistically significant between the.2.0mm aperture group and the 3.0mm pore group. There was no significant difference in P0.05. The results of.Micro-CT scan showed that there were more new bone in the material center of the 1.0mm aperture group and the bone density was significantly higher than the other two groups at the 12 week, and the bone around the material also had bone tightly wrapped around the material. The.2.0mm and 3.0mm pore size groups had bone wrapping around the material, but there was no bone formation in the center cavity. The results were consistent with histological findings.
Conclusion:
The bone length of the porous titanium alloy material is influenced by the size of the material. For the large pore structure, the pore size beyond a certain range will affect the growth of the new bone, and the proper design of the pore size will be more beneficial to the bone conduction of the material.
Experimental two porous titanium alloy / beta tricalcium phosphate composite materials with different pore sizes to repair bone defects
Objective:
Objective to evaluate the effect of porous titanium alloy / beta tricalcium phosphate composite material on the repair of long bone defects in dogs.
Method:
Two porous titanium alloy materials with different apertures (2.0mm, 3.0mm) were prepared by electron beam melting (EBM). The pore size was 1.0cm x 1.0cm x 1.0cm square, and the pores were filled with beta tricalcium phosphate (beta -TCP). The 8 adult dogs were randomly divided into two groups, each group was 4. The damage model, the size of the defect area and the size of the material, two kinds of pore diameter composite materials were implanted into the lateral condyle defect area of the femur respectively. The left side was 2.0mm group and the right side was 3.0mm group.3 months later. General observation, X-ray observation, and histological observation were made to understand the integration of the two kinds of pore size composite and the surrounding bone.
Result:
The X - ray showed that the two groups of porous composite materials were all connected to the surrounding bone at 3 months. There were different degrees of osteogenesis and bone formation from the periphery to the center. The histological observation showed that there was a gap between the 2.0mm aperture group and the surrounding bone at 3 months, and the bone trabeculae arranged around the sparse.3.0mm aperture group and the center had a large number of new bone tissue. As a result, the bone trabecula was closely arranged, and the number was obviously more than that of the 2.0mm aperture group. The percentage of the new bone area (14.65%1.12%) of the surrounding bone and the material combined with the tight.2.0mm aperture group (14.65%1.12%) was significantly less than that of the 3.0mm pore group (25.95%1.11%). The difference was statistically significant, P0.01. conclusion:
The pore size of porous titanium alloy / beta tricalcium phosphate composite material affects the growth of the new bone, and the combination of artificial bone and porous titanium alloy will change the bone growth behavior of the original porous metal material.
【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R318.08

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本文編號：2070487