异体松质骨植骨打压紧密度对植骨转归影响的实验研究

目的：探索不同的打压紧密度对打压植骨转归的影响，以寻求一个定量的指标来指导打压植骨的紧密度。方法：新西兰大白兔30只，其中3只处死后取松质骨制备植骨材料，另外27只随机分成A、B、C3组（n=9），左股骨远端髁部建立腔隙性骨缺损并植骨。植骨紧密度在A组相当于松质骨密度，B组为0．85ρ皮质骨，C组为0．75ρ皮质骨。分别于第4、8、12周每组处死3只试验兔进行x线、骨密度仪检测，大体观察和组织病理切片观察。结果：X线检测，术后12周A组植骨区域密度低于周围正常松质骨组织，和周围松质骨界线较明显，B、C组8周、12周时植骨区域和周围正常松质骨间无明显界线；经过3个月改建，B、C组植骨区和对侧正常松质骨区骨密度差异小。病理观察术后12周C组和A组植骨周围区仍可见骨母细胞（C组多于A组），B组植骨区和周围正常区骨小梁连续，未见骨母细胞。结论：紧密打压植骨有利于移植骨早期改建塑形。当植骨区紧密度为0．85ρ皮质骨时，可以实现紧密打压植骨。

An Experimental Research on the Outcome of Impacted Cancellous Bone Allograft with Different Compactness

Objective ：To expore the effect of compactness on the outcome of impaction bone allograft in order to seek a quantitative criteria to guide bone grafting. Methods：30 New Zealand white rabbits , of which 3 were killed for taking cancellous bone to the preparation of graft material , and 27 were divided into three groups （ n = 9）. Lacunar bone defect was made in the left distal femoral condyle. Group A ： the compactness of bone graft was equivalent to cancellous bone mineral density. Group B： bone graft tightness was 0.85ρ cortical bone. Group C： bone graft tightness was 0.75 ρ cortical bone. Three rabbits were sacrificed at 4th,8th, 12th week in each group for X - ray , bone mineral density testing , general observation and histopathology observation. Results：X - ray detection： after 12 weeks , in group A ,the density of bone graft area was lower than the surrounding normal cancellous bone , between which a obvious boundary was seen. In group B, C, at 8th week, 12th week, without a distinct boundary between the bone graft area and the surrounding normal cancellous bone. After 3 months rebuilding, in group B and C, bone mineral density was similar between bone graft district and eontralateral normal cancellous bone district. Pathology observation, after 12 weeks, in group C and group A, around bone graft area osteoblasts were still visible （group C more than group A）. In group B, the trabecula of the surrounding normal area was continuous to bone graft and no osteoblast could be seen. Conclusions ： The compact impaction bone allograft is conducive to the early rebuilding of grafting bone. when the bone graft district tightness is 0.85ρ cortical bone, compact bone grafting can be achieved.