摘要
激素性股骨头坏死是由长期或大量使用类固醇激素而引起的一种非创伤性骨坏死.激素性股骨头坏死晚期通常会发生股骨头塌陷,需要进行关节置换手术.患者不仅要支付昂贵的治疗费用,还面临术后无菌性松动的风险.为延缓股骨头塌陷,在激素性股骨头坏死早期和中期进行保髋治疗具有重要的临床意义.合适的动物模型对研究激素性股骨头坏死的发病机制、评价药物预防和治疗效果至关重要.本文针对激素性股骨头坏死动物模型、预防及治疗激素性股骨头坏死的实验研究进行文献回顾.家兔模型常用于激素性股骨头坏死的病因学及病理学研究,可用于研究药物对激素性股骨头坏死发病率的影响,还可用于评价药物在激素性股骨头坏死中期对成骨性修复的改善作用,进而预测药物防治股骨头塌陷的效果.四足动物的股骨头解剖结构和受力特征与人类不同,不能发展为股骨头塌陷.双足动物中鸵鸟激素性股骨头坏死塌陷模型,可用于评价髓芯减压术联合活性可降解骨修复材料的应用降低股骨头塌陷率方面的治疗效果.基于对激素性股骨头坏死常用动物模型及在此基础上探索病理生理学特征的文献回顾,提示长期或大剂量应用激素早期使用药物干预可有效降低骨坏死发生率,激素性股骨头坏死中期行髓芯减压术联合组织工程技术可降低股骨头塌陷的风险,为股骨头坏死保髋治疗提供思路.
Steroid associated-osteonecrosis(SAON)is non-trauma induced osteonecrosis,which is induced by long-term or high dose of corticosteroid indicated for inflammatory or immune diseases,etc.Subchondral collapse at late stage of SAON usually needs to be treated with joint replacement,while the costs and the prognosis of the surgery are challenge.It is important to perform the fundamental researches on the hip preservation treatments of SAON at early stage,and it is necessary to establish suitable animal models for studying the mechanisms of SAON and evaluating the potential treatments for the SAON.Rabbit SAON model is the most frequently used animal model.It is extensively used in studies on etiology and pathology of SAON.Furthermore,it is possible to evaluate potential drugs for preventing SAON and improving osteogenic repair of mid-stage SAON to prevent joint collapse.Because of bi-pedal,emu has the similar mechanical properties with human.Thus,it can be a suitable animal model for studying preventions and treatments of subchondral collapse of SAON,such as core-decompression with biodegradable materials for bone regeneration.In conclusion,this review updates the current animal SAON models with similar pathology to clinical SAON.These typical models could be used as clinical references for investigating drugs in prevention of early-stage of SAON and biomaterials in hip-preservation surgery for mid-stage of SAON.
作者
王新峦
郑力真
曹会娟
秦岭
Wang Xinluan;Zheng Lizhen;Cao Huijuan;Qin Ling(Translational Medicine R&D Center,Institute of Biomedical and Health Engineering,Shenzhen Institutes of Advanced Technology,Chinese Academy of Sciences,Shenzhen 518055,China;Musculoskeletal Research Laboratory,Department of Orthopaedics&Traumatology,the Chinese University of Hong Kong,HKSAR,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2019年第23期1462-1469,共8页
Chinese Journal of Orthopaedics
