脱钙异体骨关节移植的初步实验研究

An experimental study of massive demineralized osteoarticular allograft transplantation

目的 探索利用脱钙异体骨关节移植修复节段性骨关节缺损。方法 在 2 4只新西兰兔的双侧桡骨近段造成 2 0mm长的骨关节缺损 ,分别移植脱钙异体骨关节和不移植骨关节 ,对照观察骨关节缺损的修复情况。术后 2～ 2 4周作X线照片、组织学检查和生物力学试验。结果 脱钙异体骨关节移植后 ,诱导生成新的骨关节 ,其形态和力学特征近似正常骨关节 ,没有出现关节退变、粘连或僵硬 ,关节功能基本正常。结论 脱钙异体骨关节具有低抗原性和高骨诱导能力的特点 ,可作为临床上重建节段性骨关节缺损的理想移植材料。

Objective To study the effect of demineralized osteoarticular allograft(DOAA) transplantation on the repair of segmental osteoarticular defects.Methods Twenty four mature male New Zealand white rabbits were used to test the osteochondrogenic potential of DOAA in the repair of segmental osteoarticular defects.A twenty millimeter osteoarticular defect was created bilaterally in the proximal part of radii.The defects were grafted with DOAA transplants or ungrafted.The healing of defects was then assessed by serial radiographic and histologic studies and biomechanical test from two to twenty four weeks after surgery. Results The bones and cartilages newly formed were induced after DOAA transplantation.The regenerated bone and cartilage closely resembled normal bone and cartilage,and its mechanical properties were comparable to intact bone.No degeneration and arthrokleisis appeared in the radio humeral joints and the functions of the joint were proximately normal.Conclusion DOAA transplantation has low antigenicity and high bone inductive and cartilage inductive capacity.It may be an ideal available material for clinical use in reconstruction of segmental osteoarticular defect.