Braun C
Abteilung für Unfallchirurgie, Chirurgische Universitätsklinik, Homburg/Saar, Federal Republic of Germany.
Arch Orthop Trauma Surg. 1992;111(5):250-4. doi: 10.1007/BF00571518.
Conventional bone allografts carry a high incidence of complications such as infections and pseudarthroses due to immunological rejection and avascularity of grafts. In vascularised grafts healing and remodelling of bone is quicker and more complete. However, vascularised allografts need immunosuppression for prevention of rejection with vascular occlusion. Autogenously vascularised allografts are formed after implantation of bone in muscle of the recipient, allowing vascularisation from this muscle. A muscle-bone composite graft is thus obtained that can be transferred as a pedicled or free graft with microvascular anastomosis. In this study donors were DA and recipients Lewis rats. The bone grafts were implanted in the adductor muscles and transferred after 6 weeks into a femoral defect. A higher number of osteocytes were found in the autogenously vascularised group than in non-vascularised grafts. "Creeping substitution" was found in all cortical layers in vascularised grafts, whereas in conventional allografts bone resorption predominated. The experimental data suggest that in rat autogenously vascularised bone allografts show a remodelling pattern comparable with that of conventional vascularised bone autografts. The advantage of the autogenously vascularised bone allograft is that it allows transfer of a vascularised bone allograft together with its well-vascularised recipient bed without immunosuppressive treatment.
传统骨移植因免疫排斥和移植骨缺血而导致感染和假关节等并发症的发生率很高。在带血管移植中，骨的愈合和重塑更快且更完全。然而，带血管移植骨需要免疫抑制以预防排斥反应和血管阻塞。自体带血管移植骨是在将骨植入受体肌肉后形成的，可从该肌肉获得血管化。这样就得到了一种肌肉 - 骨复合移植体，可作为带蒂移植体或通过微血管吻合进行游离移植。在本研究中，供体为DA大鼠，受体为Lewis大鼠。将骨移植体植入内收肌，6周后转移至股骨缺损处。自体带血管化组的骨细胞数量比非带血管化移植体中的更多。在带血管移植体的所有皮质层均发现了“爬行替代”现象，而在传统同种异体移植中骨吸收占主导。实验数据表明，在大鼠中，自体带血管化骨移植体呈现出与传统带血管化自体骨移植体相当的重塑模式。自体带血管化骨移植体的优点在于，它无需免疫抑制治疗即可将带血管化骨移植体与其血管化良好的受体床一起转移。
