大块脱钙异体骨关节移植:脱钙异体骨关节制备的研究

The transplantation of massive demineralized osteoarticular allograft:a study in preparation of demineralized osteoarticular allograft

目的：探讨制备脱钙异体关节（ＤＯＡＡ）的最佳脱钙时间和关节软骨保护方法。方法：在１８只新西兰兔的双侧桡骨近段造成２０ｍｍ长骨关节缺损，随机分成３组，分别移植固体石蜡保护关节软骨的ＤＯＡＡ、石蜡油保护的ＤＯＡＡ和不加保护的ＤＯＡＡ。术后４～２４周作大体活检、Ｘ线照片和组织学检查。结果：２４ｈ脱钙与４８ｈ脱钙的ＤＯＡＡ在骨诱导能力方面没有明显差别，但后者因脱钙时间长，骨质较软而致诱导生成的新生骨关节有明显畸形。固体石蜡保护的ＤＯＡＡ诱导关节软骨再生的能力明显优于其他两组。结论：用固体石蜡保护关节软骨并将脱钙时间控制在２４ｈ是制备ＤＯＡＡ的较理想方法。

Objective:To investigate the best time for decalcifying and the protective covering of cartilage in the preparation of the demineralized osteoarticular allograft(DOAA) Methods:A twenty millimeter osteoarticular defect was created bilaterally in the proximal part of the radii of eighteen mature male New Zealand White rabbits The rabbits were divided into three groups In Group 1 and 2,the defects were transplanted respectively the DOAA that cartilage was protected by hard paraffin (DOAAhp) ro liquid paraffin The defects in Group 3 were grafted DOAA that cartilage was naked The DOAA grafted in the defects of left or right radii in all three groups was demineralized for 24 hours (DOAA24h) or 48 hours (DOAA48h) respectively The healing of defects was then assessed by biopsy,histologic and radiographic studies from four to twenty four weeks after surgery Results:The bone inductive capacity was no different between the DOAA24h and DOAA48h However,the newly formed bones that were induced by DOAA48h was more deforming than that were induced by DOAA24h since the decalcifying time of DOAA48h was longer so that the quality of the bone was softer The cartilagc inductive capacity of Group of DOAAhp was superior obviously to other two groups Conclusion:It may be an ideal method for preparing the DOAA that cartilage is protected by hard paraffin and decalcifying time is 24 hours