自体骨膜移植修复骨关节软骨缺损(附14例报告)

PERIOSTEAL AUTOTRANSPLANTATION TO REPAIR OSTEOARTICULAR CARTILAGE DEFECT WITH A REPORT OF 14 CASES

目的 探讨自体骨膜移植修复关节软骨缺损及骨不连。方法 对 1 4例骨不连或难愈性骨折、髋、膝关节结核、滑膜软骨瘤行病灶清除或清理 ,植骨、减压而有软骨缺损 ,采用游离自体骨膜或带阔筋膜张肌蒂胫骨骨膜或带缝匠肌蒂髂骨骨膜移植。结果 髋、膝、踝关节功能不同程度恢复 ,无融合或强直 ,患者恢复工作 ,日常生活可自理 ,疼痛完全解除。带阔筋膜张肌蒂胫骨骨膜移植血运建立快 ,成软骨作用强 ,修复骨缺损 ,增强抗炎能力。结论 自体骨膜游离或带蒂移植 ,对关节软骨缺损、难愈性骨折、骨缺损或不连均有一定的成骨、成软骨作用 ,修复重建功能效果好。

Objective To investigate the repairment opf articutar cartilage defect and nonunion with periosteal autotransplantation. Methods 14 cases with nonunion or refractory fracture or synovial chondromatosis of hip and joint or cartilage defect received focal cleaning and bone grafting and decompressing. The transplantation was performed by using free periosteal or tibial periosteal or with muscular tensor fasciae latae or hip bone's periosteral with tailor's muscle. Results The functions of hips, knees, ankles and joints were recovered at various levels without fusion or rigidity. All the patients resumed their work and normal daily life, with their pain relieved completely. Blood circulation after transplantation of tibial periosteal with musculus tension fasciae latae was established quickly with strong function of chondroplast restored, the bone defects repaired and the ability of anti-inflammatory enhanced. Conclusion Free auto-transplantation or transplantation with pedicle periosteal has to some extent the osteogenic and chondroplast function to articular cartilage and bone defects and refractory fracture or nonunion of bone. The function of recovery can be effective.