Hernigou Philippe
Orthopaedic Surgery, Hopital Henri Mondor, Creteil, France,
Int Orthop. 2015 Jan;39(1):193-204. doi: 10.1007/s00264-014-2578-5. Epub 2014 Nov 15.
In the 18th century, the fate of allografts and their role in bone formation became of interest to many orthopaedic surgeons. A controversy over the science of osteogenesis, the formation of bone, had emerged following the opposing views of Duhamel and von Haller. Duhamel noted that the periosteum had a deep osteogenic layer, which he termed the "cambium layer". However, von Haller claimed the opposite: the periosteum was not osteogenic. In the 19th century, Ollier performed comprehensive studies on the periosteum. Ollier's experiments were published in two volumes entitled "Traite Experimental et clinique de la regeneration des os" in 1867. His conclusion was that transplanted periosteum and bone survived and could become osteogenic under proper conditions. The controversy was furthered by MacEwen who believed, contrary to Duhamel and Ollier, that the periosteum had no osteogenetic power and was purely a limiting membrane giving direction to bone growth but taking no active part in it. This manuscript describes this period of controversies about the osteogenesis of the transplanted bone, marrow and periosteum that would eventually die or not and be replaced by surrounding tissue or be active for osteogenesis. Whether bone grafts are a form of passive scaffolding or active in osteogenesis was the main question about auto and allografts in the 18th and 19th centuries. In response to this challenge, many papers were written to defend each side of the argument.
在18世纪,同种异体移植的命运及其在骨形成中的作用引起了许多骨科医生的关注。在杜哈梅尔和冯·哈勒的对立观点之后,关于骨生成(即骨的形成)科学出现了一场争论。杜哈梅尔指出骨膜有一个深层的成骨层,他称之为“形成层”。然而,冯·哈勒却持相反观点:骨膜不具有成骨能力。19世纪,奥列尔对骨膜进行了全面研究。奥列尔的实验发表在1867年出版的两卷本《骨再生的实验与临床研究》中。他的结论是,移植的骨膜和骨能够存活,并且在适当条件下可以具有成骨能力。麦克尤恩进一步加剧了这场争论,他与杜哈梅尔和奥列尔的观点相反,认为骨膜没有成骨能力,纯粹是一层为骨生长提供方向但不积极参与其中的限制膜。本手稿描述了关于移植骨、骨髓和骨膜成骨的这一争论时期,即它们最终是否会死亡,是否会被周围组织取代,或者是否会积极参与成骨。在18和19世纪,骨移植是一种被动支架形式还是在成骨过程中发挥积极作用,是自体移植和同种异体移植的主要问题。针对这一挑战,人们撰写了许多论文来为争论的双方辩护。