用自体骨膜包裹肌腱 - 松质骨匀浆复合体为月骨替代物的实验研究

目的：观察自体肌膜包绕肌腱－松质骨匀浆复合体植入动物关节腔后组织形态学改变，为替代月骨治疗月骨无菌性坏死提供实验依据。方法：选新西兰白兔45只，按手术先后顺序随机分为骨膜组、复合体组和对照组3组，每组15只兔。将上述三种植入分别植入兔膝关节腔内。术后3，6，12，16及24周取标本观察组织形态变化并测量CT值。结果：对照组呈玻璃样变性，形成片状瘢痕。骨膜组织复合体组均有软骨和骨形成，但后组尤为明显，标本CT值经统计学方差分析组间差别有非常显著性意义（P＜0．01）。结论：骨膜包绕肌腱－松质骨匀浆复合体在骨膜、松质骨匀浆诱导下可形成大量肌和软骨，具有较好支撑作用，可用作月骨替供物。

Experimental study on compound of autologous periosteum - wrapped tendon and spongiosa homogenate as substitute for the lunate

Objective To observe morphological and histological changes after compound of autologous periosteum wrapped tendon and spongiosa homogenate was implanted into articular cavity in animal, and provide experimental evidence for semilunar bone substitute for Kienbock's disease. Methods 45 healthy New Zealand white rabbits were randomly divided into three groups : periosteum group (A), composite group (B), and control group (C), 15 in each. The three sorts of implants were placed into articular cavity of the knee in rabbits respectively. Histological and morphological changes were examined and CT value determined at 3,6,12,16,24 weeks postoperatively. Results There was hyaline degeneration and patch scar in control group. In periosteum group (A) and composite group (B),there was cartilage and bony forming, especially in the latter group. There was significant statistical difference of CT values between the groups. Conclusions These results demonstrated that, under the induction of periosteum and spongiosa hemogenate, the compound of autologous periosteum wrapped tendon and spongiosa hemogenate can produce bone and cartilage massively and can be used as the substitute for lunate.