Tägil Magnus, Aspenberg Per, Astrand Jörgen
Department of Orthopedics, Lund University Hospital. SE-221 85 Lund, Linköping, Sweden.
Acta Orthop. 2006 Feb;77(1):23-6. doi: 10.1080/17453670610045650.
Cartilage degeneration often occurs after osteosynthesis of a devascularized intermediary fragment in a joint fracture, in mosaicplasty or in whole-joint toe-to-finger transplantation. Hypothetically, the degeneration is secondary to a collapse of the transferred subchondral bone as it remodels during high mechanical load. Bisphosphonates are used to reduce resorption of necrotic bone. We tested a systemic pretreatment before harvesting the graft in order to protect the bone and cartilage against collapse and secondary arthrosis.
Rats were given one zoledronate injection and bone grafts were harvested. The grafts were frozen, thawed and placed into bone chambers, and implanted into another batch of rats. Graft resorption and new bone formation was measured by histomorphometric analysis and compared with untreated grafts.
In the remodeled area of the controls, the graft was almost totally resorbed and replaced by bone marrow. In the zoledronate-treated specimens, the graft remained and the graft trabeculas were lined with new bone. By histomorphometry, the total amount of bone (graft plus new bone) within the remodeled area was 16% in the zoledronate-treated grafts and 5% in the controls (p = 0.003).
A bone graft can be pretreated with bisphosphonate and remain protected against resorption once implanted again.
在关节骨折、镶嵌植骨或全关节趾-指移植中，当对无血运的中间骨块进行接骨术时，软骨退变经常发生。据推测，这种退变继发于移植的软骨下骨在高机械负荷下重塑过程中的塌陷。双膦酸盐用于减少坏死骨的吸收。我们测试了在采集移植物之前进行全身预处理，以保护骨和软骨免于塌陷及继发性关节病。
给大鼠注射一次唑来膦酸后采集骨移植物。将移植物冷冻、解冻并放入骨腔，然后植入另一批大鼠体内。通过组织形态计量学分析测量移植物吸收和新骨形成情况，并与未处理的移植物进行比较。
在对照组的重塑区域，移植物几乎完全被吸收并被骨髓替代。在唑来膦酸处理的标本中，移植物保留，移植物小梁表面有新骨形成。通过组织形态计量学分析，唑来膦酸处理的移植物重塑区域内的骨总量（移植物加新骨）为16%，而对照组为5%（p = 0.003）。
骨移植物可用双膦酸盐进行预处理，再次植入后仍能免受吸收。
