脱钙异体骨关节移植诱导成骨和成软骨作用的研究  

Studies on the Bone and Cartilage Inductive Capacity of Demineralized Osteoarticular Allograft Transplantation

作　　者：李斯明 张胜泉 杨小红 查健群 

机构地区：[1]广州市创伤外科研究所 [2]广州市红十字会医院病理科

出　　处：《中华骨科杂志》1998年第6期367-370,I004,共5页Chinese Journal of Orthopaedics

摘　　要：目的：评价脱钙异体骨关节（ＤＯＡＡ）移植诱导成骨和成软骨的作用。方法：将２４只成年雄性新西兰兔随机分成两组。除Ⅰ组左侧桡骨作为正常对照外，余均截去桡骨近段２０ｍｍ，包括骨膜和关节软骨，分别移植脱钙异体骨关节（ＤＯＡＡ组）和不移植（ＵＧ组）。术后２～２４周做Ｘ线检查、组织学检查和生物力学试验。结果：ＤＯＡＡ移植后诱导生成新的骨关节。新生骨关节经过塑形，其形态特征、组织学特性和生物力学性质均类似正常骨关节；而ＵＧ组则未见新生骨关节形成，缺损区的骨断端变尖变硬。从组织切片中发现，ＤＯＡＡ移植后关节软骨的再生主要有两个途径：（１）纤维组织中成纤维细胞化生的成软骨细胞转化为软骨细胞；（２）移植骨中新生软骨细胞的爬行替代。其营养既来自宿主的滑液，也来自软骨下骨的新生毛细血管。移植骨的再生则是膜内化骨和软骨内化骨协同作用的结果。结论：ＤＯＡＡ具有骨诱导和软骨诱导能力。?Objective:To evaluate the bone and cartilage inductive capacity of demineralized osteoarticular allograft (DOAA) transplantation. Methods: Twenty four mature male New Zealand white rabbites were divided into two groups. A twenty millimeter osteoarticular defect was created in all the proximal part of radii except the left radii in Group Ⅰ that was served as normal control. The defects were grafted with DOAA transplants or ungrafted (UG). The healing of defects was then assessed by serial radiographic and histologic studies and biomechanical tests from two to twenty four weeks after surgery. Results: After transplantation, the DOAA grafts induced the regeneration of bones and cartilages forming. By remodeling, the newly formed bones and cartilages more closely resembled normal bone and cartilage in both morphology and histology, and its mechanical properties were comparable to intact bone. No newly formed bones and cartilages were seen in UG group, in which the cut end of the radii became sharp and hardened. From the histologic sections in this study, it was found that the regeneration of the cartilage was mainly in two ways: (1)the chondroplast which was metaplastic from fibroblast in fibrous tissue transformed chondrocyte, and (2) the chondrocyte derived from bone graft grew inwards and replaced the cartilage. The nutrition of regenerated cartilage came from both synovia and newborn capillaries in the subchondral bone. The regeneration of bone graft was the results of intramembranous ossification in cooperation with endochondral ossification. Conclusion: The DOAA graft is possessed of bone inductive and cartilage inductive capacity and may induce the regeneration of bones and cartilages after transplantation.

关 键 词：脱钙 骨关节移植 骨诱导 软骨诱导 异体移植 

分 类 号：R687.34[医药卫生—骨科学]