组织工程骨植骨临床应用七年随访结果

目的 总结生物衍生组织工程骨植骨临床应用的中期效果.方法 2000年12月-2001年6月,采用同种异体骨膜来源的成骨细胞1×106/mL与生物衍生骨支架材料构建组织工程骨,经体外培养3～7d后,植入修复10例骨缺损.男6例,女4例年龄14～70岁,中位年龄42.其中骨囊性病变2例,陈旧性骨折不愈合1例,新鲜粉碎性骨折伴骨缺损6例,慢性化脓性骨髓炎1例.每例患者植入生物衍生组织工程骨量3～15g,平均7.3 g.结果 10例患者术后伤口均Ⅰ期愈合.术后获随访7年,除1例于术后1年发生植骨松动外露取出,以及1例并发创伤后肱骨头坏死取出外,其余植骨均在术后3.0～4.5个月达骨性愈合.X线片检查除1例患者已行肱骨头切除术外,其余均达到骨愈合,骨皮质连续,重塑良好.患肢功能能满足日常生活及工作需要.结论 生物衍生组织工程骨具有良好的成骨能力,临床应用中期效果良好,未见明显排斥反应及并发症.

CLINICAL APPLICATION OF BIO-DERIVED BONE TRANSPLANTATION WITH TISSUE ENGINEERING TECHNIQUE: 7 YEAR FOLLOW-UP

OBJECTIVE: To summarize the medium-term clinical result of bio-derived bone transplantation in orthopedics with tissue engineering technique. METHODS: From December 2000 to June 2001, 10 cases of various types of bone defect were treated with tissue engineered bone, which was constructed in vitro by allogenous osteoblasts from periosteum (1 x 10(6)/mL) with bio-derived bone scaffold following 3 to 7 days co-culture. Six men and 4 women were involved in this study, aged from 14 to 70 years with a median of 42 years. Among them, there were 2 cases of bone cyst, 1 case of non-union of old fracture, 6 cases of fresh comminuted fracture with bone defect, and 1 case of chronic suppurative ostemyelitis. The total weight of tissue engineered bone was 3-15 g in all the cases, averaged 7.3 g in each case. RESULTS: The wound in all the case healed by first intention. For 7 year follow up, bone union was completed within 3.0 to 4.5 months in 9 cases, but loosening occurred and the graft was taken out 1 year after operation in 1 case. The X-ray films showed that 9 cases achieved union except one who received resection of the head of humerus. No obvious abnormities were observed, and the function of affected limbs met daily life and work. CONCLUSION: Bio-derived tissue engineered bone has good osteogenesis. No obvious rejection and other complications are observed in the clinical application.