3D打印多孔支架结构对钛合金假体植入物骨整合能力的影响

发布时间：2018-05-23 11:56

本文选题：假体植入物 + 3D打印多孔支架　；参考：《吉林大学》2017年硕士论文

【摘要】：背景:自第一例人工关节假体植入手术始,假体植入物的稳定性就备受关注。但假体植入物的稳定性仍未达到令人满意的水平,例如在全膝关节置换手术中,多种原因导致的宿主骨-假体植入物接触面的不稳定可以产生机械损伤、无菌性松动、失稳、假体周围骨折等诸多问题,最终使假体植入物脱落、异位[1]。这使患者在不得不延长住院时间、饱受身体与精神摧残的同时还要承担额外的经济负担,所以,进一步提高术后假体植入物在宿主骨骼内的稳定性,变得尤为重要。随着研究的进展人们发现,要想使植入物获得良好的稳定性,需要宿主骨与假体植入物之间存在生物形式的结合,即骨性结合;而良好的骨性结合,需要植入物具备“多孔”的特征。骨性结合观念与“多孔”概念的提出,开辟了假体植入物设计的新领域,人们开始设计各种3D打印多孔支架用以研究假体植入物与宿主骨骨性结合的情况,从而提高假体植入物骨性结合的能力。在当今骨科植入物的临床应用中,最常见的材料是Ti6Al4V,其生物相容性好、弹性模量低、耐腐蚀等优点都备受瞩目,使之成为使用最广泛的医用钛合金相关材料。故本研究选用Ti6Al4V做为材料,从骨的生物学性质与骨性结合的要求出发,依托3D打印多孔支架,研究多孔结构对假体植入物骨整合能力的影响。目的:本研究通过评价3D打印钛合金多孔支架在体内及体外实验中促进成骨细胞分裂分化、以及骨组织长入的能力,探讨多孔结构对假体植入物骨整合能力的影响。方法:在本次实验中,将分别检测300um与500um两种不同孔径的3D打印钛合金多孔支架。在体外实验部分,进行流式细胞凋亡实验、细胞增殖实验、细胞形貌及黏附实验、碱性磷酸酶定量实验;在体内实验部分,我们选取适龄雄兔作为实验动物,将支架通过外科手术植入兔股骨髁,饲养4周后取材,通过Micro-CT与组织学染色进行骨长入分析。结果:两种不同孔径的3D打印钛合金多孔支架均无细胞毒性,在体外实验部分,两者骨髓间充质干细胞增殖的差距无统计学意义,体内实验部分,可以看出300um孔径的支架周围有更多的新骨形成,且骨长入孔径内程度较深。结论:支架的多孔结构对于支架的骨整合能力至关重要,且孔径对支架的骨整合能力存在影响,合适的支架结构可以促进骨组织的长入,从而使假体植入物在宿主骨内更加稳固。在体外实验中300um孔径的支架并未明显刺激骨髓间充质干细胞的增殖,但可以提高支架促进成骨分化的能力,体内实验中,相较500um孔径,300um孔径支架在周围与内部均形成了更多的骨组织,也证实了这一点。
[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.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R318.08

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