Abstract:

Objective To investigate the efficacy of core decompression plus collagen⁃based bone repair materialsand vascular endothelial growth factor（VEGF）in the treatment of femoral head necrosis（ONFH）in rab⁃ bits. Methods A model ofrabbit ONFH was established by injecting absolute ethanol into the femoral head of 30 rabbits. Then the rabbits were randomly divided intoahealthy control group（group A），model group（group B）， core decompression plusautologous cancellous bone group（group C），core decompression plus collagen ⁃ based bone repair material group（group D），and core decompression plus collagen⁃based bone repair materialandVEGF group（group E），6 in each group. After 8⁃week treatment，the morphology of tissues was observed by hematoxylin and eosin（HE）staining. Rabbit whole blood viscosity（high shear 150 s ⁃1 and low shear 10 s ⁃1 ），plasma viscosity， hematocrit，serum total cholesterol（TC）and triglyceride（TG）were measured. mRNA levels of von Hippel⁃Lindau （VHL），hypoxia⁃inducible factor alpha（HIF⁃1α），VEGF，and basic fibroblast growth factor（bFGF）in femoral head tissue were detected by qRT⁃PCR. Results As compared with groups C and D，whole blood viscosity（high shear 150 s⁃1 and low shear 10 s⁃1 ），plasma viscosity and hematocrit were significantly decreased in group E（P < 0.05）；so were serum TC and TG（P < 0.05）. In comparison with groups C and D，level of VHL mRNA in the femoral head tissue was significantly decreasedin group E，while HIF⁃1α，VEGF and bFGF were significantly increased（P < 0.05）. Conclusions Core decompression combined with collagen⁃based bone repair material and VEGF can effectively accelerate osteogenesis and vascular repair in the injured area of ONFH rabbits and reduce microcirculation disturbance. Its mechanism is related to improvement of lipid metabolism and regulation of VHL/HIF⁃1α/VEGF signal and bFGF expression. 

Key words:

femoral head necrosis, core decompression, collagen?based bone repair material, vas? cular endothelial growth factor, microcirculation, vascular repair