Hofmann G O, Kirschner M H, Wangemann T, Falk C, Mempel W, Hammer C
Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Klinikum Grosshadern, München, Germany.
Arch Orthop Trauma Surg. 1995;114(3):159-66. doi: 10.1007/BF00443390.
Allogeneic transplantation of human cancellous and cortical bone is a controversially discussed concept in trauma and orthopaedic surgery. Biological and immunological arguments support transplantation of autologous material whenever this is technically possible. On the other hand, synthetic alloplastic materials for bone substitution are available free of immunological and hygienic hazards. In this context the value of allogeneic bone grafts is discussed, especially considering the problem of AIDS. If autologous corticospongious bone is to be used its supply is limited. On the other hand, alloplastic synthetic artificial bone does not meet all the requirements demanded for substitution of large osseous defects up to now. The problems of geometric and mechanical stability of these alloplastic materials still remain. Therefore, no alternative to allografting of large, stable, corticospongious fragments exists in some cases. Bone transplantation is performed without vital indication in nearly every case. Thus an optimum of hygienic security has to be claimed for recipients of allogeneic bone. The "Munich model" for bone transplantation is presented and discussed.
人松质骨和皮质骨的同种异体移植在创伤和矫形外科领域是一个备受争议的概念。只要技术上可行，生物学和免疫学观点都支持自体材料移植。另一方面，用于骨替代的合成异体材料不存在免疫学和卫生学风险。在此背景下，讨论了同种异体骨移植的价值，尤其是考虑到艾滋病问题。如果要使用自体皮质松质骨，其供应有限。另一方面，合成异体人工骨目前尚未满足替代大骨缺损的所有要求。这些异体材料的几何和机械稳定性问题仍然存在。因此，在某些情况下，不存在替代移植大的、稳定的皮质松质骨碎片的方法。几乎在每种情况下，骨移植都没有明确的生命指征。因此，必须为同种异体骨接受者确保最佳的卫生安全。本文介绍并讨论了骨移植的“慕尼黑模型”。
