| Background:osteonecrosis of the femoral head,also known as avascular necrosis of the femoral head,is a chronic disease caused by various factors,including bone marrow cell ischemia and osteocyte necrosis.As the disease progresses,the structure of the femoral head is often altered until it collapses[1].It is one of the most effective methods to treat early and mid-term osteonecrosis by using autogenous bone graft combined with core decompression.However,the autologous bone donor site is limited,and the clinical bone is often used as an alternative material.There is a risk of transmission disease.Therefore,there is currently a lack of a suitable bone substitute material.The development of tissue engineering scaffold provides a new idea for solving these difficulties.Objective:To evaluate the effect of icariin-beta-tricalcium phosphate composite scaffold materials for bone repair of rabbit femoral head necrosis,bone repair stent to understand bone stock and influence the ingrowth of blood vessels,in order to evaluate icariin-beta-tricalcium phosphate composite scaffold can be used as avascular necrosis of bone repair material.Methods:Fortity 3 months to 3 and a half of adult male New Zealand rabbits,according to previous research group model[2],made of rabbit femoral head necrosis model by horse serum and dexamethasone,27 rabbits were randomly selected for femoral head necrosis rabbits,and 27 femoral head necrosis rabbits were randomly divided into three equal groups:autogenous bone group(group A),beta-tricalcium phosphate group(group B),ICA-beta-tricalcium phosphate group(group C),9 rats in each group.On the same day,femoral head necrosis in rabbits with femoral head necrosis underwent hip preserving surgery(core decompression and bone graft).The left side was taken as the operative side.In the group A,the iliac bone was implanted into the femoral head,the group B was implanted with the P-TCP stent,and the group C was implanted with ICA-β-TCP stent.Since the date of surgery in each group respectively in fourth,eighth,twelfth over the weekend to ear vein air injection method executed 3,MICRO-CT scan was performed on the sample image analysis for the implant-bone interface histopathology(HE staining,MASSON staining and TRAP staining)to evaluate ICA-β-TCP phosphate scaffold effects on bone repair,to observe vascular ingrowth for immunohistochemical staining of VEGF.Results:combined with HE staining and MRI scan,31 rabbit models of femoral head necrosis were successfully established.The success rate of the model was 9.The success rate of the model was 77.5%.After stent implantation were observed by HE staining:group A,new bone trabeculae at fourth weeks,eighth,twelfth weeks when the bone trabeculae orderly,fusion with autogenous bone;group B fourth weeks graft bone interface shows a large number of empty bone lacuna,no obvious bone repair,repair for eighth weeks in the group B area of empty bone lacuna decreased,osteoblasts,was observed after twelfth weeks of new trabecular bone ingrowth into the scaffolds;the group C in the fourth week temporal bone lacuna more,bone repair phenomenon of the weak,eighth weeks of empty bone lacuna was significantly reduced,more new bone at twelfth weeks,both inside and outside the stent trabecular bone ingrowth.The bone repair in group A at the same time point was better than that in the other two groups,and the group B was the weakest.MASSON staining:group C in and around the stent internal bone trabecula,contains a wealth of empty bone lacuna and bone cells,with the time prolonging,the collagen matured,bone repair tends to be stable;the A group also saw Liang Shengcheng bone obviously,and with the increase of bone repair time,autologous bone graft bone line bone area gradually blurred disappear;group B bone repair is weak.TRAP staining showed that the number of osteoclasts decreased with the process of bone repair.Compared with group B,the number of osteoclasts in group C was significantly reduced compared with group B at three time points,and the difference was statistically significant.However,there was no significant difference in the number of osteoclasts in group B and group A.The number of cells decreased significantly compared with the other two groups.VEGF immunohistochemical staining results:from time to time,the expression of VEGF in the 3 groups gradually increased with the extension of repair time.From the group perspective,at the same time,the expression of VEGF in group B was higher than that in group B,but lower than that in group A,MICRO-CT imaging observation:at fourth weeks,there was no obvious trabecular bone around the stent in the β-TCP group.There was a slight shadow in the ICA-β-TCP group and the autogenous bone group,which was considered as the repair band.At the eighth week,ICA-β-TCP group could see small bone formation at the scaffold host bone junction.At twelfth weeks,the scaffold was degraded obviously,surrounded by dense trabecula.In group β-TCP,the trabecular bone was sparse and arranged in disorder in the same period compared with the other two groups.12 weeks later,group of New Zealand rabbits were operated side femoral implant bone junction can support high density,bone junction area and internal stent bone formation,with the time after the operation,the trabecular bone ingrowth is better,the more structure tends to be orderly.But in general,the A group had the best bone growth,the bone trabecula was more compact,the structure was orderly,and the bone repair in group B was the weakest.Conclusion:ICA-β-TCP composite scaffold has significant effect on bone repair of osteonecrosis of the femoral head.It can inhibit osteoclast activity while promoting osteoblast production,and promote angiogenesis by Icariin release.It is effective for the treatment of rabbits with femoral head necrosis,so 3D printing ICA-β-TCP scaffold is a promising bone repair material. |
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