Tenholder Mark J, Kneisl Jeffrey S, Harrow Matthew E, Peindl Richard D, Stanley Kevin J
Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.
Am J Orthop (Belle Mead NJ). 2003 Jun;32(6):289-97.
The best method for processing allograft bone to prevent disease transmission without compromising its biomechanical function is not yet determined. We evaluated the biomechanical effects of processing bulk allograft bone segments with negative-pressure washing. Specimens were prepared from matched pairs of adult cadaveric femurs. The experimental femur underwent routine processing, followed by negative-pressure washing, whereas its matched control underwent routine processing only. Each specimen was tested to failure, and maximal stress values were determined. No differences were found in yield stress comparisons between groups for the following specimens and tests: compression of machined femoral heads, screw push-out testing in cortical bone, and 4-point bending of cortical beams. Compression testing of diaphyseal ring struts provided varied results. Negative-pressure-washed half-ring strut grafts were statistically stronger (9.6%) than their matched controls (P = 0.018). Negative-pressure-washed full-ring strut grafts were statistically less strong (-12.2%) than their control counterparts (P = 0.003). We studied 5 different allograft types (designed with clinically relevant geometries) subjected to 3 modes of testing (representative of loading in typical clinical situations). Our data show that processing of large, essentially intact allograft bone segments with negative-pressure washing had little, if any, biomechanical effect relative to frozen controls.
目前尚未确定在不损害其生物力学功能的情况下处理同种异体骨以预防疾病传播的最佳方法。我们评估了用负压冲洗处理大块同种异体骨段的生物力学效果。标本取自成年尸体股骨的匹配对。实验股骨先进行常规处理，然后进行负压冲洗，而其匹配的对照仅进行常规处理。每个标本测试至失效，并确定最大应力值。在以下标本和测试的组间屈服应力比较中未发现差异：加工后股骨头的压缩、皮质骨中的螺钉推出测试以及皮质梁的四点弯曲。骨干环形支柱的压缩测试结果各异。经负压冲洗的半环形支柱移植物在统计学上比其匹配的对照更强（9.6%）（P = 0.018）。经负压冲洗的全环形支柱移植物在统计学上比其对照对应物更弱（-12.2%）（P = 0.003）。我们研究了5种不同的同种异体移植物类型（设计有临床相关的几何形状），并进行了3种测试模式（代表典型临床情况下的负荷）。我们的数据表明，相对于冷冻对照，用负压冲洗处理大的、基本完整的同种异体骨段几乎没有生物力学影响（如果有影响的话也很小）。
