ABSTRACT
OBJECTIVE: To observe the effect of recombinant human bone morphogenetic protein 2/poly-lactide-co-glycolic acid (rhBMP-2/PLGA) with core decompression on repair of rabbit femoral head necrosis. METHOD: Bilateral femoral head necrosis models of rabbit were established by steroid injection. A total of 48 rabbits (96 femoral head necrosis) were randomly divided into 4 groups: Group A, control group with12 rabbits, 24 femoral head necrosis; Group B, treated with rhBMP-2/PLGA implantation after core depression, with 12 rabbits, 24 femoral head necrosis; Group C, treated with rhBMP-2 implantation after core depression, with 12 rabbits, 24 femoral head necrosis; Group D treated with core depression group without implantation, with 12 rabbits, 24 femoral head necrosis. All animals were sacrificed after 12 weeks. The ability of repairing bone defect was evaluated by X-ray radiograph. Bone mineral density analysis of the defect regions were used to evaluate the level of ossification. The morphologic change and bone formation was assessed by HE staining. The angiogenesis was evaluated by VEGF immunohistochemistry. RESULTS: The osteogenetic ability and quality of femoral head necrosis in group B were better than those of other groups after 12 weeks by X-ray radiograph and morphologic investigation. And the angiogenesis in group B was better than other groups. Group C had similar osteogenetic quality of femoral head necrosis and angiogenesis with group D. CONCLUSION: The treatment of rhBMP-2/PLGA implantation after core depression can promote the repair of rabbit femoral head necrosis. It is a promising and efficient synthetic bone material to treat the femoral head necrosis.
ABSTRACT
OBJECTIVE: to investigate the clinical efficacy of arthroscopic debridement, shaping and soft tissue releasing in the treatment of severe elbow osteoarthritis and ankylosis. METHODS: arthroscopies were performed in 34 patients with severe elbow osteoarthritis. Among them, 13 were accompanied by ankylosis. In arthroscopic surgery, articular cavity was cleared. And loose bodies, osteophytes of coronoid process and olecranon of ulna were excised, the coracoid fossa and olecranon fossa shaped and joint capsules and collateral ligaments severely contracted properly released. Rehabilitation training was guided postoperatively. Arthralgia and range of motion of elbow were scored by Mayo's scoring criteria in contrast with that preoperatively. RESULTS: the pain and range of motion (ROM) of elbow improved obviously in 34 patients. Angle of extension postoperatively increased by 30° ± 16° and angle of flexion increased by 34° ± 19°. Postoperative ROM of elbow show significant difference with the preoperative status (P < 0.01). According to the Mayo's scoring criteria, the excellent and good rate was 85.3%. CONCLUSION: arthroscopic treatment of severe osteoarthritis and ankylosis of elbow is reliable. Trauma of arthroscopy is minimal and complications are rare.
