[A comparison study on autologous periosteum-wrapped tendon and spongiosa homogenate as a substitute for lunate].

OBJECTIVE

To study and compare bone-forming mechanism after compound of autologous periosteum-wrapped tendon with spongiosa homogenate and other implants in articular cavity, and to explore the possibility of the compound as a substitute for the lunate in Kienbock's disease.

METHODS

Forty-five New Zealand white rabbits were randomly divided into three groups: periosteum group (group A, n=15), composite group (group B, n=15), and control group (group C, n=15). The three sorts of implants were placed into articular cavity of the knee respectively. The changes of bone formation and bone morphogenetic protein (BMP) distribution of the implants were examined under optical microscope with HE and immunohistochemical staining and measured by CT 3, 6 and 9 weeks after operation.

RESULTS

The result of BMP staining was negative after 3 weeks and positive in new cartilage cells after 9 weeks in group A. The positive BMP staining was observed in group B after 3 weeks and 9 weeks, which mainly distributed in new bone cells and cartilage cells. And negative BMP staining was observed every stage in group C. The quantitative CT bone mineral density (BMD) values of 3 implants were analyzed, the difference was significant between the groups (P<0.01), except that between groups A and C in the 3rd week (P>0.05).

CONCLUSION

The above results demonstrated that the compound of autologous periosteum-wrapped tendon and spongiosa homogenate can produce bone and cartilage massively under the induction of periosteum and bone-forming factors such as BMP in spongiosa homogenate and the compound can be used as a substitute for the lunate.