Nyman R, Sennerby L, Nyman S, Lundgren D
Department of Radiology, University Hospital, Uppsala, Sweden.
Scand J Plast Reconstr Surg Hand Surg. 2001 Sep;35(3):239-46. doi: 10.1080/028443101750523140.
Defects 10 mm long were created in long bone in the diaphysis of both radii of 18 rabbits (test and control side). On the test side, ingrowth of bone marrow into the defects was hindered or delayed by: plugging the opening of the cut bone ends with gutta-percha points (n = 7); plugging with Gelfoam (n = 6); or by removing the bone marrow by flushing with saline (n = 5). The defects on both test and control side were covered with an expanded polytetrafluoroethylene membrane, shaped as a tube. Healing was followed with radiographs for four to five months, after which the animals were killed and ground sections of the areas of the defects were prepared for histological examination. On the control side, nine of 18 animals had complete osseous bridging of the defect, and a small transverse non-mineralised zone remained in the centre of the healed defect in the other animals. This zone consisted of loose connective and cartilagenous tissue as well as connective tissue obviously derived from the outside of the membrane. By preventing or delaying the ingrowth of bone marrow we retarded the regeneration of mineralised bone, particularly in the gutta-percha and flushed bone marrow groups. The principle of guided tissue regeneration may be used to achieve regeneration of extensive long-bone defects. Any attempts to delay or prevent bone marrow ingrowth into the defects did retard regeneration of segmental long-bone defects.
在18只兔子的双侧桡骨干骺端的长骨中制造了10毫米长的缺损（试验侧和对照侧）。在试验侧，通过以下方式阻碍或延迟骨髓向缺损处的长入：用牙胶尖堵塞切断的骨端开口（n = 7）；用明胶海绵堵塞（n = 6）；或用生理盐水冲洗去除骨髓（n = 5）。试验侧和对照侧的缺损均用管状的膨体聚四氟乙烯膜覆盖。用X线片随访愈合情况4至5个月，之后处死动物，制备缺损区域的磨片用于组织学检查。在对照侧，18只动物中有9只缺损完全被骨桥接，其他动物愈合的缺损中央残留一小片横向的非矿化区域。该区域由疏松结缔组织、软骨组织以及明显源自膜外的结缔组织组成。通过阻止或延迟骨髓长入，我们延缓了矿化骨的再生，尤其是在牙胶尖组和冲洗骨髓组。引导组织再生的原理可用于实现广泛长骨缺损的再生。任何延迟或阻止骨髓长入缺损的尝试都会延缓节段性长骨缺损的再生。
