离体时间对自体骨移植愈合影响的实验研究

Experimental study on influence of storage time in vitro on bone autograft healing

目的 :探讨自体移植骨离体 4h内对移植骨成骨能力的影响。方法 :取兔髂骨常温下置于 0 .9%生理盐水中 ,分别于取骨后 0、1、2、3、4h行异位肌袋植骨 ,植骨分冲洗与不冲洗骨髓两种。异位肌袋植骨行ALP染色、PAS染色和HE染色等组织形态学检查和形态计量学分析。结果 :组织学检查显示术后 3天各组移植骨中均有骨细胞和成骨细胞成活 ,但无新骨形成。术后 1周各组均有新骨样组织形成 ,2周新骨组织增多 ,其后新骨组织增多并逐渐向编织骨和板层骨组织转变。形态计量学分析结果显示异位肌袋植骨各组没有显著性差异。结论 :取骨后置于 0 .9%生理盐水中 4h内对自体移植骨本身的成骨能力没有影响 ,冲洗骨髓并不影响移植骨的成活以及成骨能力 ,故将移植骨取下后置于 0 .9%生理盐水中是合理的方法 ,取骨后立即植骨或取骨后 4h内再植入对自体移植骨的愈合没有明显影响。

Objective:To discover the influence within four hours of different storage time in vitro on the osteogenic capability in bone autograft.Methods:The ilium blocks in 0.9% saline were kept at room temperature for 0、1、2、 3 or 4 hours before replacement to extra-skeletal muscle gaps in the same rabbit.The grafts transplanted to muscle gaps were divided into two types:irrigating bone marrow with saline and non-irrigating bone marrow.The histological specimens of the autograft in extra-skeletal muscle gaps were taken at the 3rd day and 1、2、4、6 weeks after operation, stained by ALP.PAS and HE,and analysed by histomorphometry.Results:There were survival osteocytes and osteoblasts in all ectopic graft groups three days after operation,but no new bone formation.New osteoid tissues were formed one week after operation, and they increased at the second week and were gradually transformed into woven bone and lamellar bone tissues in all ectopic graft groups. The results of histomorphometry analysis showed there was no remarkable difference among all ectopic graft groups.Conclusion:Storage of the bone blocks in 0.9% saline for four hours before implant has no remarkable influence on the capacity of bone formation in bone autograft.Irrigating bone marrow with saline would not influence the survival of autograft and the capacity of new bone formation.Therefore,it is a reasonable method to keep bone blocks in saline before implant.