González del Pino J, Gómez Castresana F, Benito M, Weiland A J
Department of Orthopaedic Surgery, Hospital La Paz Autónoma University School of Medicine, Madrid, Spain.
J Reconstr Microsurg. 1990 Apr;6(2):151-9. doi: 10.1055/s-2007-1006816.
In 15 mongrel adult dogs, an ischemic necrosis of the femoral head was produced, following the technique described by Gartsman and colleagues. Five weeks later, a 6- to 8-cm long rib graft was harvested with its vascular bundle and transferred into the previously induced ischemic femoral head. Microsurgical anastomoses were performed for revascularizing the rib graft. Dogs were studied using scintigraphy, blood flow measurements, roentgenograms, angiograms, and histology at four, eight and 12 weeks after grafting. New bone and vascular formation was exhibited throughout the study, as demonstrated by a highly positive scintigraphic activity and the formation of numerous arterial terminal branches arising from the rib graft circulation which entered the femoral head and reached the subchondral plate. The formerly necrotic femoral head bone exhibited osteoblastic activity, viable osteocytes, and well-populated bone marrow. The rib graft was also incorporated into the femoral head. These results suggest that a vascularized bone graft is able to repair a femoral head necrosis, and may be considered a rational approach for clinical purposes.
在15只成年杂种犬身上，按照Gartsman及其同事所描述的技术制造了股骨头缺血性坏死。五周后，切取一段6至8厘米长带有血管束的肋骨移植物，并将其转移至先前诱导产生缺血的股骨头处。进行显微外科吻合术以使肋骨移植物重新血管化。在移植后4周、8周和12周，使用闪烁扫描法、血流量测量、X线片、血管造影和组织学对犬进行研究。在整个研究过程中均显示有新骨和血管形成，闪烁扫描活性高度阳性以及从肋骨移植物循环发出的众多动脉终末分支形成，这些分支进入股骨头并到达软骨下板，证明了这一点。先前坏死的股骨头骨表现出成骨细胞活性、存活的骨细胞以及细胞丰富的骨髓。肋骨移植物也融入了股骨头。这些结果表明，带血管骨移植物能够修复股骨头坏死，并且可被认为是一种合理的临床治疗方法。
