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软骨移植作为手指关节植入置换术的辅助手段。

A cartilagenous graft as an adjunct to finger joint implant arthroplasty.

作者信息

Powers D L, Worthy F L, von Recum A F

出版信息

J Biomed Mater Res. 1985 May-Jun;19(5):509-18. doi: 10.1002/jbm.820190504.

Abstract

A method is described which is proposed to prolong the functional life of a Silastic finger joint endoprosthesis which has been shown to fail because of abrasion and cutting by the recipient bones. Swanson design Silastic finger joint prostheses were implanted into the knee joints of rabbits. The technique of simultaneously transplanting ear cartilage to the prosthetic implant bed was tested for the purpose of protecting the prostheses from wear and eventual failure. The clinical, radiographic, gross, and histologic results of the animals implanted for 1, 3, and 6 months show that the cartilage graft remains viable and it proliferates. The cartilage provides a smooth, gliding surface with normal appearing joint fluid surrounding the Silastic implant. Control limbs, with no cartilage grafts, had thinner, fibrous tissue encapsulating the implants. The presence of the cartilage reduced the amount of prosthetic wear particles observed in the tissue sections, thus indicating a protective function. The rabbit model developed an osteoarthritis that was caused by the prostheses in its knee joints and was unaffected by our cartilage grafting procedure. The success of our cartilage grafts, in the presence of such an arthritis, provides the impetus for its clinical use in arthritic human finger joints. Further studies are necessary to determine the clinical feasibility of a cartilage grafting technique and its efficacy in reducing implant failure in human finger joints.

摘要

本文描述了一种方法,该方法旨在延长硅橡胶手指关节假体的功能寿命,这种假体已被证明会因受植骨的磨损和切割而失效。将斯旺森设计的硅橡胶手指关节假体植入兔膝关节。为保护假体免受磨损及最终失效,测试了将耳软骨同时移植到假体植入床的技术。对植入1个月、3个月和6个月的动物进行的临床、影像学、大体及组织学检查结果显示,软骨移植物保持存活并增殖。软骨为硅橡胶植入物提供了一个光滑的滑动表面,其周围有关节液,外观正常。未进行软骨移植的对照肢体,其植入物周围包裹着更薄的纤维组织。软骨的存在减少了在组织切片中观察到的假体磨损颗粒数量,从而表明其具有保护功能。兔模型出现了由膝关节假体引起的骨关节炎,且不受我们软骨移植手术的影响。在存在这种关节炎的情况下,我们的软骨移植取得成功,这为其在患有关节炎的人类手指关节中的临床应用提供了动力。有必要进一步研究以确定软骨移植技术的临床可行性及其在减少人类手指关节植入物失效方面的疗效。

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