髋臼周围损伤对髋关节发育影响的实验研究

目的：探讨髋臼软骨及周围骨膜损伤对髋关节发育的影响。方法：4-5周龄白兔20只，切除其右饲髋关节部分髋臼软骨(A组)及臼缘上方骨膜(B组)，左侧作为对照。用X线、形态学及组织学方法观察髋关节发育状况。结果：右侧全部出现髋关节发育不良，半脱位发生率：A组80％，B组40％。对照侧发育正常。结论：髋臼软骨及臼缘上方骨膜破坏可导致髋关节发育不良和半脱位。     

髋臼Y形软骨损伤对髋关节发育影响的实验研究

目的探讨“Y”形软骨损伤后骨骺早闭对髋关节发育的影响。方法选用10只4~5周龄大白兔,切除、破坏右侧髋臼部分“Y”形软骨,左侧髋关节不行处理,作为对照。X线动态观察双侧髋关节发育状况,术后12周处死动物,进行形态学及组织学观察。结果手术侧术后3周“Y”形软骨均出现骨骺早闭,髋臼内壁增厚、髋臼变浅;术后6~9周髋臼浅且形态不规则,4例出现半脱位;术后12周全部出现关节发育不良,50%的髋关节发生半脱位。形态学观察见髋臼变浅,内壁厚度增加,股骨头增大、变扁,关节软骨失去光泽,部分缺失。HE染色见髋臼及股骨头软骨层变薄,软骨细胞排列紊乱,骺板扭曲、变薄。对照侧各髋关节形态结构正常。手术侧各期臼头指数、相对髋臼指数及臼壁厚度与对照侧相比差异均有显著性意义(P<0.05)。手术侧术后12周臼头指数及相对髋臼指数与术后第2d相比差异有非常显著性意义(P<0.01)。结论“Y”形软骨损伤可导致骨桥形成、骨骺早闭,使髋臼内壁增厚、髋臼变浅,继而引发髋关节发育不良和半脱位。     

髋臼加深全髋置换治疗成人先天髋臼发育不良

目的：探索成人先天性髋臼发育不良伴髋关节半脱位的手术治疗方法。材料和方法：12例成人先天性髋臼发育不良伴髋关节半脱位患者采用髋臼加深髋关节置换的方法治疗。结果：经1－8年随访,段体稳定,髋关节疼痛症状消失,关节功能基本正常。结论：髋臼加深全髋关节置换是成人先天性髋臼发育不良伴髋关节半脱位的有效治疗方法。     

髋臼周围组织松解治疗婴幼儿先天性髋脱位的效果观察

[目的]探讨髋臼周围组织松解治疗婴幼儿先天性髋关节脱位的临床应用价值。[方法]采用Smith-Peterson切口，对38例50髋的髋关节脱位患者进行髋臼周围组织松解复位。[结果]术后随访12个月～5a，平均18．3个月。获准确复位者50髋，达同心圆复位者31髋，内侧间隙仍宽者11髋，头臼覆盖欠佳者8髋。随访末期髋臼指数恢复正常者36髋，股骨头骨骺坏死0髋，再（半）脱位0髋。[结论]髋臼周围组织松解术是治疗先天性婴幼儿髋脱位的重要、有效手段。     

改良髋臼周围截骨阶梯状植骨术治疗大龄儿童先天性髋关节脱位

目的：探讨大龄儿童先天髋脱位的手术方法。方法：采用改良髋臼周围截骨，阶梯状植骨术治疗大龄儿童先天性脱位48例62髓关节，并进行随访观察。结果：得到随访45例47髋，关节位置同心复位良好，无1例发生脱位及半脱位，关节功能恢复良好。结论：改良髋臼周围截骨阶梯状植骨术是治疗大龄儿童先天性髋关节脱位较理想的方法。     

先天性和陈旧性髋关节脱位的全髋置换术

目的 探讨先天性髋关节脱位和陈旧性髋关节脱位患者人工全髋关节置换术的适应证和髋臼假体安放位置的选择.方法 先天性髋关节脱位10例(13髋)和陈旧性髋关节脱位6例(6髋),均采用改良Gibson入路,髋臼假体安放在髋关节假臼位置,关闭切口时尽可能修复髋关节周围软组织结构.结果 16例均经1～3年随访,疗效评定参照Charnley标准,关节功能优10例(11髋),良好3例(5髋),可3例(3髋).结论 先天性髋关节脱位和陈旧性髋关节脱位人工全髋关节置换术的髋臼假体位置的选择不能一概而论,应根据移位的远近、骨质条件和重建软组织平衡的难易程度而定.     

利用计算机图像动态观察先天性髋脱位复位后髋臼的形态变化

目的 通过计算机图像处理技术对正常及脱位髋关节Ｘ线片进行处理。了解髋臼的形态变化。方法 先天性髋脱位经手法复位患儿３３例,共４９髋,男１２例,女２１例;单侧脱位１７例,双侧脱位１６例（其中２２髋随访期间行切开复位,故将该２２髋删除）。以单侧髋脱位患者的对侧正常髋关节为对照组（１７髋）,手法复位后髋臼发育良好组为１９髋,髋臼发育不良组为８髋,将复位前后各时期髋关节的正位Ｘ线片输入计算机,并叠加在一起,计算髋臼的横向生长速度、纵向缎斜速度及其比值。结果 髋臼横向生长与纵向倾斜速度的比值分别是：对照组２４．６９５,复位后发育良好组１０．３５０,复位后发育不良组２．１１５,对照组的髋臼顶壁沿水平方向向外侧生长,６～８岁以后髋臼外侧缘逐渐向下方生长,手法复位后发育良好组６～８岁以后无骨臼外侧缘逐渐向下方生长。手法复位后髋     

青少年先天性髋关节脱位的治疗

先天性髋关节脱位(以下简称先髋)的病理改变随着年龄增加而逐渐复杂、严重,治疗也越困难。青少年先髋以高位脱位、头臼严重发育畸形和髋周软组织严重挛缩为其主要特征。治疗上存在着三大并发症即术后再脱位、股骨头无菌性坏死及关节僵硬。因此,其治疗一直是国内外矫形外科的棘手问题。本文对青少年先髋的治疗及有关问题综述如下:1 青少年先髋的主要病理解剖改变1.1.髋臼的病理改变 髋臼的发育停滞,相对地变浅、变小,盂唇缩窄内翻,臼内脂肪纤维组织填充,圆韧带增生肥厚或消失,臼横韧带相对地向中心内移,真臼脱出口形成骨嵴,以及假臼形成。1.2.髋周软组织挛缩与关节囊畸变 随着股骨头向上向后移位,关节囊被牵伸拉长、增厚,嵌夹于股骨颈与髋臼之间,由于髂腰肌的压迫,关节囊呈葫芦状或闭锁呈哑铃状。髋周肌群,韧带及其筋膜随着年龄增大而发生不同程度的挛缩或延长。一般来说凡与肢体纵轴平行的肌群均挛缩,跨越髋关节与肢体纵轴垂直的肌群被拉长。1.3.股骨近端的病理改变 股骨头高位脱位往往发育停滞。股骨头变小,畸变致头臼大小及形态不相称。颈干角增大髋外翻畸形。前倾角增大,小粗隆前移。     

髋臼发育不良髋臼缘生物力学测定

[目的]证实由于兔髋臼发育不良，股骨头被髋臼所覆盖的面积减少，股骨头的球状关节和髋臼的舟状关节负重面趋于集中，头臼关节不能耐受高度集中的强大的机械应力作用，最终导致髋关节脱位．[方法]本实验利用七V13型数据采集记录仪、X线片和组织病理切片对对照组和实验组髋关节进行力学测定和病理学观察一[结果]实验组髋臼缘软骨逐渐发生退变和变形，髋臼缘A、B、C、D4点位置，所受应力均有变化。对照组和实验组，t检验，P〈0．01。[结论]本实验对髋臼发育不良兔髋臼缘力学测定，可以推测人类先天性髋关节脱位的机理和原冈与髋臼发育不良有密切联系。先天性髋关节脱位患儿应早期发现，早期治疗，提高临床治疗效果。     

牵引复位有限制动治疗先天性髋脱位的疗效观察

本文报告采用牵引复位有限制动的功能性方法治疗小儿先天性髋脱位并对其疗效进行了观察。治疗分三个阶段：（１）伸直位牵引；（２）外展位牵引并实现自动复位；（３）功能性外展架中度屈曲外展位有限制动。从１９８３～１９９５年采用该法治疗４岁以下先天性髋脱位４３５例６０６髋，女３６６例，男６９例，年龄２０天～４岁。按Ｔｎｎｉｓ分度：Ⅰ度脱位１４１髋，Ⅱ度１０４髋，Ⅲ度２４７髋，Ⅳ度１１４髋。随访２～１１年，平均５．５年，复位成功率９８％。根据周永德的评定标准，按脱位程度进行疗效评价，总优良率为９２％，股骨头缺血性坏死率３．９％，再脱位１０髋占１．６％。作者认为充分的伸直位和外展位牵引，自动复位，中度屈曲外展位有限制动，有效地避免了头臼间压力增高及其对股骨近端血供的影响，明显减少了股骨头缺血性坏死，并且髋关节的同心圆运动促进了髋臼的发育，提高了复位率和髋臼发育的优良率。这一方法是治疗婴幼儿先天性髋脱位的有效疗法。     

Buchbesprechungen/Book Reviews

Book reviewed in this article: Scheunert, A., und A. Trautmann: Lehrbuch der Veterinär-Physiologie . Bearbeitet von K. Bronsch, J. Brüggemann, H. Eder, H. Erbersdobler, K. Gärtner, D. Giesecke, H. Hill, G. Hofecker, V. Horn, H. HÖrnicke, A. Kment, H. Petry, H.-P. Sallmann, J. Schole, H. Spörri, J. Tiews, G. Vogel, A. Wels, G. Wittke, K. Zerobin, H. Zucker. Ueberreiter, O.: Klinische Krebsforschung bei Tieren. Meske, Christoph, Ahrensburg, und Ernst Pfeffer, GÖttingen, unter Mitwirkung von J. Matthiesen, GÖttingen; K. H. Ney, Hamburg; A. Pieper, GÖttingen; V. Potthast, GÖttingen; H. D. Pruss, Hamburg; und J. Reimers, Kiel: Ernährungsphysiologische Untersuchungen an Karpfen und Forellen. Fiedler, W.: Tiergarten Schönbrunn — Geschichte und Aufgabe. 197 Hennig, Arno, und Siegfried Poppe: Abprodukte tierischer Herkunft als Futtermittel. 232 Muller, G. H., und R. W. Kirk: Small Animal Dermatology. 809 Seiten, 2^rd edition. Verlag W. B. Saunders Company     

BOOK REVIEWS

Book Reviews in this article. GASTROINTESTINAL HAEMORRHAGE Edited by Peter W. Dykes , MD, FRCP FRACP and Michael R. B. Keighley , MS FRCS. CLINICAL AND RADIOGRAPHIC INTERPRETATION OF FACIAL FRACTURES By Amil J. Gerlock , Jr ., MD, Douglas P. Sinn , DDS, and Kevin L. Mc Bride , DDS COLOUR ATLAS OF GYNAECOLOGY By Norman A. Beischer , MD, BS, MGO, FRCS, (Ed.), FRACS, FRCOG, FRACOG and Eric V. Mac Kay , MB, BS, MGO, FRCS, (Ed.), FRACS, FRCOG, FRACOG, FACOG (Hon) ADVANCES AND TECHNICAL STANDARDS IN NEUROSURGERY Volume 8 Edited by H. Krayenbuhl DISPLACEMENT OFTHEHIP IN CHILDHOOD: AETIOLOGY, MANAGEMENT ANDSEQUELAE By Edgar W. Somerville , MA, FRCS, FRCS (Ed.) INTESTINAL FISTULAS By John Alexander -Williams , MD, ChM, FRCS, FACS and Miles Irving , MD, ChM, FRCS CLINICAL SURGERY INTERNATIONAL VOLUME 3 TISSUE TRANSPLANTATION Edited by Peter J. Morris , PhD, FRCS, FRACS DISEASES OF THE GASTROINTESTINAL TRACT AND LIVER By David J. C. Shearman , PhD, MBChB, FRCP, (Ed.), FRACP, and Niall D. C. Finlayson , PhD, MBChB, MRCP (Lond.), FRCP (Ed.)     

Unfallkrankengut Mehrfachverletzungen von 1953–1967

Ohne Zusammenfassung Unter Mitarbeit von:G. Best, E. B?ke, M. Braun, W. Brechmann, A. Encke, B. Hasper, I. Joppich, K. Junghanns, F. Kappey, H. Krebs, O. Kühn, J. Kürschner, H. Lambert, H. Leitner, P. Lichtenauer, M. L. Matthes, K. Munzinger, M. Nuri, K. Pittius, H. Rudolph, K. Schmittinger, M. Schoeyb, H. Schüler, E. v. Wedelstedt, Ch. Wehmer, St. Wysocki, D. Zeidler, H. J. Zimper Datenverarbeitung: IBM Datenverarbeitungsanlage/360 Modell 30Gerhild Braun, Claus K?hler Graphik:F. Heinrich Photo:H. Kramer, Jutta Matthes R?ntgen:W. Wenz     

同种异体椎间盘移植的实验研究

本研究是在自体椎间盘移植实验研究的基础上进一步通过Ｘ线、组织病理、生物学活性、生物化学和生物力学探索异体椎间盘移植是否可存活、功能及其归宿。１２只猴随机分为４组，移植术后３、６、９和１２个月分别处死检测。结果表明移植间盘高度术后下降，但１２个月时仍保持正常高度的６１．４％。光镜下未见明显排斥反应，终板和纤维环结构无明显改变，术后早期可见移植间盘终板软骨增生现象，髓核基质密度增大，成软骨样纤维细胞增生明显。３Ｈ－ｐｒｏｌｉｎｅ掺入较对照组明显增加。术后移植间盘的蛋白多糖和水含量降低，而胶原含量增加。生物力学动态变化表明术后早期移植间盘有失稳趋势，晚期则稳定性恢复。上述结果显示同种异体移植间盘可存活，生化代谢虽有变化但有一定的自限性，形态结构无明显改变，生物力学满足功能需要。     

Perioperative mortality and morbidity in the year 2000 in 520 certified training hospitals of Japanese Society of Anesthesiologists: with a special reference to age--report of Japanese Society of Anesthesiologists Committee on Operating Room Safety

Perioperative mortality and morbidity in Japan for the year 2000 were studied retrospectively. Committee on Operating Room Safety of Japanese Society of Anesthesiologists (JSA) sent confidential questionnaires to 794 Certified Training Hospitals of JSA and received answers from 67.6% of the hospitals. We analyzed their answers with a special reference to the age group. The total number of anesthetics available for this analysis was 910,757. All cases were divided into 7 age groups; group A (< 1 months), group B (< 12 months), group C (< 5 years), group D (< 18 years), group E (< 65 years), group F (< 85 years), and group G (> 85 years). The incidences of all critical events including cardiac arrest, severe hypotension, and severe hypoxemia were 70.04, 42.06, 17.79, 15.57, 21.14, 39.66, and 44.65 per 10,000 in patients with group A, B, C, D, E, F, and G, respectively. The overall mortality rates (death during anesthesia and within 7th postoperative day) were 26.94, 5.91, 1.88, 2.57, 5.23, 11.98, and 17.50 per 10,000 anesthetics in patients with group A, B, C, D, E, F, and G, respectively. The incidences of cardiac arrest were 28.29, 8.54, 3.56, 2.57, 5.08, 10.27, and 11.47 per 10,000 in patients with group A, B, C, D, E, F, and G, respectively. The mortality rates after cardiac arrest were 18.86, 4.60, 1.26, 1.57, 2.77, 5.50, and 6.64 in patients with group A, B, C, D, E, F, and G, respectively. The incidence of all critical events, the incidence of cardiac arrest, and the overall mortality rate were much higher in group A than in other groups, but much lower than those in 1999. The incidences of all critical events and the mortality rate after cardiac arrest were lowest in group C. Mortality and morbidity due to all kinds of causes including anesthetic management, intraoperative events, co-existing diseases, and operation were as follows. The incidences of all critical events attributable to co-existing disease were the highest in these four groups, and 32.33, 13.80, 5.86, 4.43, 7.50, 15.34, and 21.72 per 10,000 in patients with group A, B, C, D, E, F, and G, respectively. The incidences of all critical events attributable to anesthetic management were 13.47, 16.43, 6.28, 3.86, 4.08, 6.87, and 6.64 per 10,000 in patients with group A, B, C, D, E, F, and G, respectively. The incidence of cardiac arrest in group A was much more attributable to co-existing disease and operation than other causes. The incidences of cardiac arrest attributable to anesthetic management were 0.00, 1.97, 0.63, 0.29, 0.38, 0.74, and 1.81 per 10,000 in patients with group A, B, C, D, E, F, and G, respectively. Its mortality rate in each group was 0.00, 0.00, 0.21, 0.14, 0.06, 0.04, or 0.00. There were eleven cases of death or vegetative state due to anesthetic management, like improper management of airway and overdose of anesthetics. Some of them were preventable with the anesthesiologists' effort in protocol development and skilled assistance.     

Buchbesprechungen

Book reviewed in this article: Handbuch der Tierernährung . In zwei Bänden. Herausgegeben von W. Lenkeit, Göttingen; K. Breirem, Vollebekk; E. Crasemann, Zürich. Unter Mitwirkung von D. G. Armstrong, Newcastle; C. C. Balch, Shinfield; W. Bianca, Zürich; A. L. Black, Davis; K. Breirem, Vollebekk; H. Brune, Gießen; R. C. Campling, Shinfield; E. Crasemann, Zürich; A. François, Jouy-en-Josas; K. Günther, Göttingen; H. Hill, Hannover; P. N. Hobson, Aberdeen; H. Hörnicke, Hannover; B. H. Howard, Aberdeen; P. E. Jacobsen, Kopenhagen; H. Karg, München; W. Kaufmann, Kiel; R. Müller, Bonn; L. Paloheimo, Malmi; G. Pulss, Kiel; P. M. Riis, Kopenhagen; K. Rohr, Kiel; H. H. Schlubach, Starnberg; A. Schüren, Zürich; J. Tiews, München; G. Vogel, Köln; H. Zucker, München. Band I: Allgemeine Grundlagen . Leonhardt, H.: Histologie und Zytologie des Menschen.     

BOOK REVIEWS

CURRENT SURGERY OF THE HEART By Arthur J. Roberts and C. Richard Conti . Philadelphia: JB Lippincott, 1987. Illustrated, xx + 343 pages, includes index. Price: $120.00. TENDON TRANSFERS OF THE HAND AND FOREARM By Professor Richard J. Smith , md. Boston: Little, Brown and Company, 1987. Illustrated, 337 pages. Price: $165.00. PAEDIATRIC NUTRITION: THEORY AND PRACTICE By R. J. Grand , J. L. Sutphen and W. H. Dietz Boston: Butterworths, 1987. Illustrated, xii + 852 pages, includes index. Price: $215.00. PERCUTANEOUS RENAL SURGERY By S. R. Payne MS, FRCS and D. R. Webb MS, FRACS. Edinburgh: Churchill Livingstone, 2nd edn, 1988. Illustrated, xii + 153 pages, includes index. Price: $97.00. MUSCULOSKELETAL INFECTIONS By William Gillespie and Sydney Nade . Melbourne: Blackwell Scientific Publications, 1987. Illustrated, x + 398 pages, includes index, 25 cm × 17.5 cm. Price: $65.00. COLOUR ATLUS OF TRANSTHORACIC: REPAIR OF HIATUS HERNIA By Robert Pringle . London: Wolfe Medical Publications Ltd, Yearbook Medical Publications Inc. Illustrated, 62 pages, includes index. Price: $42.00.     

实验性脊柱侧弯脊柱结构变化的观察

脊柱侧弯被定义为脊柱相对正常中心线明显地弯曲伴椎体异常旋转。它在冠状面上出现不对称弯曲，在横断面上有异常旋转。所以一个合格的脊柱侧弯动物模型应具有人脊柱侧弯的特征性变化，并且简单易行，有可重复性。我们是通过单纯于兔肩胛骨与同侧股骨大转子间连以钢丝，使脊柱发育成侧弯且进行性加重椎体旋转，出现三维结构变化但不直接损伤脊柱，３组幼兔固定后３、４、５个月分别用过量异戊巴比妥钠予以处死，观察脊柱结构变化：顶椎出现楔形变并旋转；骨盆倾斜；椎间盘髓核移向凸侧；凹侧椎体生长骺板变薄，柱状增殖细胞层变得紊乱；凸侧椎板变宽而短，对侧窄而长。横断面上顶椎前后径在凹侧增宽，骨小梁密集。实验结果表明凹侧椎体生长骺板受到超高的压力而凸侧骺板受力相对小。因此凹侧骺板由于逐渐增加的超高力的作用从而使纵行生长受到抑制，椎体楔形变，脊柱侧弯进行性加重。     

Abgeschlossene und derzeit laufende adjuvante Therapieprotokolle bei Patientinnen mit operablem Mammakarzinom (II)

Summary Background: Between 1984 and 1996 4336 patients with operated breast cancer were included in trials of the Austrian breast cancer study group. Methods: Based on prognostic factors patients were randomised with 2 different treatment groups. Results: The largest ever performed oncological trial (study VI) in postmenopausal breast cancer patients is already finished. 5 other trials are open for randomisation. Conclusions: It is the intention of the Austrian breast cancer study group to accrue patients for ongoing trials in whole Austria and to increase the number of randomised patients. K. Abbrederis, Ch. Armbruster, Gabriele Barbieri, Doris Bauer, Th. Bauernhofer, S. Beller, J. Berger, O. B?ckl, A. Brunhofer, F. Burger, Ursula Denison, Elke Derstvenscheg, Ch. Dittrich, Manuela Djavanmard, W. D?ller, Daniela Eckhoff, H. Eidtmann, R. Fegerl, J. Fellinger, F. Friedrich, Sabine Fuchs, Barbara Gebhart, Friederike Gieseking, Ch. Gr?ger, Karin Haider, D. Haidinger, E. Hanzal, E. Hell, C. Hinterbuchinger, W. Horvath, W. Jonat, Daniela Kandioler, Anna-Katrin Kasparek, M. Kern, R. Kocher, Veronika Kohlmayer, R. Kolb, Ch. Kopf, S. Kriwanek, Irene Kührer, Christine Kurz, Iris Kuss, W. Kwasny, Caroline Lackner, M. Lang, O. Langer, J. Lenz, S. Leodolter, A. Lepsinger, P. Lisborg, G. Lokker, H. Ludwig, G. Luschin-Ebengreuth, H. Maass, M. Markovic, P. Mayer, M. Medl, Elisabeth Melbinger, R. Menzel, Brigitte Mlineritsch, Elke Moosbrugger, E. Moritz, Renate Moser, W. Neunteufel, A. Obermair, J. Omann, P. Oppitz, M. Pecherstorfer, A. Pertl, Catharina Pietrzak, F. Ploner, M. Pober, R. P?hnl, R. Punzengruber, Friederike Püribauer, Ch. Rass, J. Ritschl, H. Rosen, Christine Sam, L. Schiller, W. Schippinger, J. Schüller, M. Seifert, M. Smola, P. Speiser, H. Spoula, G. Steger, Birgit Steiner, H. St?ger, G. Tatzer, Susanne Taucher, J. Tschmelitsch, P. Uher, A. Unger, M. Van Trotsenburg, N. Vavra, Sonja Vogl, B. Wenky, V. Wette, A. Wiegele, G. Winter, Monika Wirth, B. Zeh, G. Zimmermann.     

引导性骨再生中内源性BMP的作用

为探讨引导性骨再生中，内源性ＢＭＰ对骨再生过程的作用而进行以下研究。手术的方法造成兔桡骨中段１０ｍｍ缺损。实验侧用硅胶膜管连结骨缺损，作为引导性骨再生模型。另一侧作为对照。１５只新西兰兔分为三组，分别于术后３，７及１４日处死，标本行组织学及ＢＭＰ免疫组化检查。切片上，距骨端１，２，５ｍｍ处设置ａ，ｂ，ｃ线。利用真彩色计算机图像分析系统在三条线上选点测量ＢＭＰ值。实验侧骨缺损区内有一个完整的血肿结构，其ＢＭＰ染色阳性，膜管外组织ＢＭＰ染色几乎完全阴性。对照侧ＢＭＰ弥散于骨缺损周围的肌肉组织中。１周时，实验侧及对照侧均可见新骨形成。２周时，对照侧已停止，实验侧仍可见持续骨再生。ＢＭＰ定量分析中，实验侧三条带的ＢＭＰ值大部分高于对照侧。实验侧和对照侧ｂ，ｃ带之间存在梯度差，但实验侧的差值小于对照侧。这不仅证明了Ｈｕｌｔｈ关于骨折间隙存在ＢＭＰ浓度梯度的假说，也显示膜在引导性骨再生中可将内源性ＢＭＰ局限于骨缺损区内，提高内源性ＢＭＰ浓度并改善其分布的作用。这有利于骨再生，可能是引导性骨再生机理之一。对照侧ＢＭＰ值１周时最高，而实验侧在２周时仍呈持续升高。这说明，内源性ＢＭＰ有两个来源：骨端吸收释放及骨形成细胞合成。