Thomas G
Rev Chir Orthop Reparatrice Appar Mot. 1976 Apr-May;62(3):295-307.
The technique and instruments of PAP, Krompecher and Jaros allow a precise preparation of the femoral head, acetabulum, femoral condyles and tibial plateau in the donor and recipient for the application of homograft transplants of joint articular surfaces of 5 millimetre thickness. In the present series, specimens were preserved by freezing at 30 degrees below zero to prevent immunologic reactions in the recipient. Immunogenic control tests in 12 patients have shown that freezing at 30 degrees below zero does not eliminate antigens in the transplant. In future, therefore, it is intended to transplant only cartilage with living cells in relation to the HLA system. The problem of prevention of infection has been solved by a special antibiotic preparation of the specimen. Radiographic examination 4 years after operation shows that only two of 12 patients had an unsatisfactory result. Function in these two hip joints is, however, better than before operation although the transplant has been partly resorbed. The technique of homograft transplantation of the hip and knee joints is suitable for young or middle-aged individuals in whom the only alternative would be an arthrodesis. For older persons a joint prosthesis is preferable.
PAP、克伦佩赫尔(Krompecher)和亚罗斯(Jaros)的技术及器械能精确制备供体和受体的股骨头、髋臼、股骨髁及胫骨平台,以用于移植厚度为5毫米的关节面同种异体移植物。在本系列研究中,标本通过在零下30度冷冻保存,以防止受体发生免疫反应。对12名患者进行的免疫原性对照试验表明,零下30度冷冻并不能消除移植物中的抗原。因此,未来打算仅移植与HLA系统相关的带有活细胞的软骨。通过对标本进行特殊的抗生素处理,已解决了预防感染的问题。术后4年的X线检查显示,12名患者中只有2名结果不理想。不过,这两个髋关节的功能虽移植物部分被吸收,但仍比手术前要好。髋关节和膝关节同种异体移植技术适用于那些唯一替代方案是关节融合术的年轻或中年个体。对于老年人,关节假体更为可取。