Delloye C
Service d'Orthopédie et de Traumatologie, Cliniques Universitaires St-Luc, Université catholoque de Louvain, Bruxelles.
Bull Mem Acad R Med Belg. 2011;166(7-9):317-26; discussion 327-8.
The place of bone allograft in contemporary orthopaedic surgery is discussed. Bone allograft can be prepared from retrieved femoral heads for fracture or osteoarthritis and are used as a filling material. Demineralized bone matrix is a cortical bone that has been exposed to a demineralizing solution. Doing so, the growth factors of the bone are exposed and will be able to induce the formation of new bone cells from the host. This osteoinductive capacity makes the graft more active in the process of its incorporation and has been successfully used in the conservative treatment of aneurismal bone cysts. Massive bone allografts can be used as a full segment of a long bone to reconstruct part of the skeleton either alone with fixation or with a prosthetic device. Except demineralized bone, any other types of bone allograft serve as a biologic passive support for the migrating cells from the host. Cellular therapy is another approach that allows, considering the extensive use of in vitro expanded bone, forming cells originating either from the bone marrow or the fat tissue of the patient. However, this approach needs further clinical validation before being fully considered in patient.
本文讨论了同种异体骨在当代骨科手术中的地位。同种异体骨可取自因骨折或骨关节炎而取出的股骨头，并用作填充材料。脱矿骨基质是一种经过脱矿溶液处理的皮质骨。通过这样做，骨的生长因子得以暴露，从而能够诱导宿主产生新的骨细胞。这种骨诱导能力使移植物在融合过程中更具活性，并已成功用于动脉瘤样骨囊肿的保守治疗。大块同种异体骨可作为长骨的完整节段，单独使用内固定或与假体装置一起用于重建部分骨骼。除了脱矿骨，任何其他类型的同种异体骨都作为宿主迁移细胞的生物被动支撑。细胞疗法是另一种方法，考虑到体外扩增骨的广泛应用，其形成细胞来源于患者的骨髓或脂肪组织。然而，这种方法在被充分应用于患者之前需要进一步的临床验证。
