骨基质明胶复合自体红骨髓及同种异体骨联合修复骨缺损

背景骨基质明胶、红骨髓和同种异体骨常被用来修复骨缺损,但三者联合移植修复骨缺损的疗效尚缺乏研究.目的评价骨基质明胶复合自体红骨髓及同种异体骨联合移植修复骨缺损的疗效.设计以诊断为依据,设立病例随访研究.地点和对象研究地点为华中科技大学同济医学院附属同济医院骨科,对象为1999-10/2002-02本院骨科收治的良性骨肿瘤和瘤样病损患者,男49例,女27例;年龄14～36岁.无其他系统疾病.干预76例良性骨肿瘤和瘤样病损患者,彻底刮除病灶或作肿瘤骨段切除,并对瘤壁作灭活处理,以同种异体骨作支架,周围填充骨基质明胶和自体红骨髓复合物.主要观察指标术后机体反应及骨缺损修复情况.结果所有病例随访时间为5～16个月,X线显示新骨形成时间为术后1.5～4个月,完全骨化的时间为术后5～9个月,骨缺损骨性愈合74例,并获得较好的关节功能,肿瘤复发2例,术后机体无明显免疫排斥反应.结论骨基质明胶、自体红骨髓、同种异体骨复合物能有效修复骨缺损,有广泛的临床应用前景.

Combined renovation ofbone defects with bone matrix gelatin,autologous red bone marrow and homograft bones

BACKGROUND: Boue matrix gelatin(BMG), autologous red bone marrow (RBM) and homograft bones are often used to repair bone defects, but the study of curative effects of combined renovation of bone defects with the three materials is rare.OBJECTIVE: To evaluate the curative effects of combined renovation of bone defects with BMG, autologous RBM and homograft bones.DESIGN: A follow-up survey study of cases depended on diagnosis was conducted.SETTING and PARTICIPANTS: The study was completed in the Department of Orthopaedics, Tongji Hospital, Tongji Medical Collage of Huazhong University of Science and Technology. The subjects were patients with benign bone tumors and tuberculate damage treated in the hospital from October,1999 to February, 2002. 49 males and 27 females, aged 14-36 years old without any other diseases.INTERVENTIONS: In 76 patients with benign bone tumors and tuberculate damage, thorough curettage of foci or bone segment removal of tumors was conducted. Tumor walls were inactivated. Homograft bones were used as support and around which BMG and autologous RBM were filled.MAIN OUTCOME MEASURES: Organism reactions and renovation of bone defects after operation.RESULTS: Time of follow-up surveys of all the cases was 5-16months. Tine of new bone formation showed by X-ray was 1.5-4 months and complete ossification was 5-9 months after operations. Totally 74 cases reached bony union and obtained preferable joint function. Tumor recurrence: 2 cases. There was no immunologic rejection after operation.CONCLUSION: The combination of BMG, autologous RBM and homograft bones can effectively renovate bone defects and has a widespread prospect in clinical application.