胚胎颅骨骨膜移植修复髋关节软骨大面积缺损  

REPAIR OF LARGE ARTICULAR CARTILAGE DEFECT OF HIP WITH ALLOGRAFT OF SKULL PERIOSTEUM

作　　者：周建生[1,2] 胡汝麒 潘功平[1,2] 徐延德 马强 蔡善保[1,2] 成筱川 洪宁 

机构地区：[1]蚌埠医学院附属医院骨科 [2]蚌埠市铁路中心医院骨科

出　　处：《中国修复重建外科杂志》1998年第3期176-179,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：安徽省卫生厅资助

摘　　要：１９９０年５月～１９９４年４月，对４２例（４７个髋）关节软骨全厚缺损患者采用冷冻保存胚胎颅骨骨膜移植进行修复，其中１４例股骨头骨质Ⅳ期坏死者，同时施行带旋髂深血管蒂髂骨植骨。对３４例（３８个髋）进行了２年～６年（平均４０个月）随访。结果表明，按照吴之康髋关节人工置换术后疗效评定标准，优良２５例，很好５例，好３例，尚可１例。认为，与自体移植物修复关节软骨大面积缺损相比，这种方法无附加损伤，具有移植材料、形态与股骨头相似等特点，是治疗髋关节软骨大面积缺损的一种有效方法。It is very difficult to repair large articular cartilage defect of the hip. From May 1990 to April 1994, 47 hips in 42 patients of large articuler cartilage defects were repaired by allograft of skull periosteum. Among them, 14 cases, whose femoral heads were grade. Ⅳ necrosis, were given deep iliac circumflex artery pedicled iliac bone graft simultaneously. The skull periosteum had been treated by low tempreturel (-40℃) before and kept in Nitrogen (-196℃) till use. During the operation, the skull periosteum was sutured tightly to the femoral head and sticked to the accetabulum by medical ZT glue. Thirty eight hips in 34 patients were followed up for 2～6 years with an average of 3.4 years. According to the hip postoperative criteria of Wu Zhikang, 25 cases were excellent, 5 cases very good, 3 cases good and 1 case fair. The mean score increased from 6.4 before operation to 15.8 after operation. The results showed, in compare with autograft of periosteum for biological resurface of large articular defect, this method is free of donorsite morbidity. Skull periosteum allograft was effective for the treatment of large articular cartilage defects in hip.

关 键 词：髋关节 关节软骨缺损 颅骨骨膜 异体移植 

分 类 号：R687.34[医药卫生—骨科学]