Kawaguchi Satoshi, Hart Robert A
Instructor and Surgeon, Department of Orthopaedics, Oregon Health and Science University, Portland, Oregon.
Instr Course Lect. 2015;64:87-93.
Because of their osteoconductive properties, structural bone allografts retain a theoretic advantage in biologic performance compared with artificial interbody fusion devices and endoprostheses. Current regulations have addressed the risks of disease transmission and tissue contamination, but comparatively few guidelines exist regarding donor eligibility and bone processing issues with a potential effect on the mechanical integrity of structural allograft bone. The lack of guidelines appears to have led to variation among allograft providers in terms of processing and donor screening regarding issues with recognized mechanical effects. Given the relative lack of data on which to base reasonable screening standards, a basic biomechanical evaluation was performed on one source of structural bone allograft, the femoral ring. Of the tested parameters, the minimum and maximum cortical wall thicknesses of femoral ring allograft were most strongly correlated with the axial compressive load to failure of the graft, suggesting that cortical wall thickness may be a useful screening tool for compressive resistance expected from fresh cortical bone allograft. Development of further biomechanical and clinical data to direct standard development appears warranted.
由于其骨传导特性，与人工椎间融合装置和假体相比，结构性同种异体骨移植在生物学性能方面具有理论优势。现行法规已针对疾病传播和组织污染风险进行了规定，但关于供体资格和骨处理问题的指导方针相对较少，而这些问题可能会对结构性同种异体骨的机械完整性产生影响。缺乏指导方针似乎导致同种异体骨供应商在处理和供体筛查方面，在公认的机械效应问题上存在差异。鉴于缺乏合理筛查标准的相关数据，对一种结构性同种异体骨来源——股骨环进行了基本的生物力学评估。在测试参数中，股骨环同种异体骨的最小和最大皮质骨壁厚与移植骨轴向压缩至失效的载荷相关性最强，这表明皮质骨壁厚可能是一种有用的筛选工具，可用于评估新鲜皮质骨同种异体骨的抗压能力。进一步开展生物力学和临床数据研究以指导标准制定似乎是必要的。
