生物衍生组织工程骨植骨的初步临床应用

目的　总结生物衍生组织工程骨用于骨科临床的初步结果。方法　 2 0 0 0年 1月～ 2 0 0 2年 1月 ,用同种异体骨膜来源的成骨细胞 1× 10 6 / ml与生物衍生骨支架材料构建的组织工程骨 ,经体外培养 3～ 7天后 ,植入修复 5 2例各种类型的骨缺损 ,其中骨囊性病变 7例 ,陈旧性骨折不愈合或畸形愈合 2 2例 ,新鲜粉碎性骨折伴骨缺损 15例 ,脊柱骨折后路植骨融合术 4例 ,牙槽骨植骨 3例 ,足跗中关节植骨融合 1例。植入组织工程骨总量为 349g,平均每例植入6 .7g。结果　术后全部病例获得随访 ,随访时间 10～ 2 8个月 ,平均随访 18.5个月。除 1例术后伤口乙级愈合外 ,5 1例均为甲级愈合。除 2例植骨延迟愈合外 ,其余 5 0例均在 3.0～ 4 .5个月内愈合。有 6例进行了 CD3、CD4、CD8及 ICAM- 1和 VCAM- 1检测 ,均未发现明显异常。结论　生物衍生组织工程骨具有良好的成骨能力 ,尚未发现明显排斥反应及其它并发症

BIO-DERIVED BONE TRANSPLANTATION WITH TISUE ENGINEERING TECHNIQUE: PRELIMINARY CLINICAL TRIAL

OBJECTIVE: To sum up the clinical results of bio-derived bone transplantation in orthopedics with tissue engineering technique. METHODS: From January 2000 to May 2002, 52 cases with various types of bone defect were treated with tissue engineered bone, which was constructed in vitro by allogeneous osteoblasts from periosteum (1 x 10(6)/ml) with bio-derived bone scaffold following 3 to 7 days co-culture. Among them, there were 7 cases of bone cyst, 22 cases of non-union or malunion of old fracture, 15 cases of fresh comminuted fracture of bone defect, 4 cases of spinal fracture and posterior route spinal fusion, 3 cases of bone implant of alveolar bone, 1 case of fusion of tarsotarsal joint. The total weight of tissue engineered bone was 349 g in all the cases, averaged 6.7 g in each case. RESULTS: All the cases were followed up after operation, averaged in 18.5 months. The wound in all the case healed by first intention, but 1 case with second intention. Bone union was completed within 3 to 4.5 months in 50 cases, but 2 cases of delayed union. Six cases were performed analysis of CD3, CD4, CD8, ICAM-1 and VCAM-1 before and after operation, and no obvious abnormities were observed. CONCLUSION: Bio-derived tissue engineered bone has good osteogenesis. No obvious rejection and other complications are observed in the clinical application.