Jerosch J, Granrath M, Clahsen H, Halm H
Klinik und Poliklinik für Allgemeine Orthopädie Westfälische-Wilhelms Universität Münster.
Z Orthop Ihre Grenzgeb. 1994 Jul-Aug;132(4):335-41. doi: 10.1055/s-2008-1039984.
Several studies demonstrated the necessity of rehydration of lyophilized bone allografts prior to implantation. The purpose of the presented study was to evaluate the influence of different rehydration periods on the stability of human cortical lyophilized and gamma-irradiated allografts, the capability of lyophilized bone for rehydration, as well as the effects of lipid extraction on rehydration. Breaking strength of lyophilized irradiated cortical bone after different rehydration periods (0.5, 1, 2, 4, 8 hours) showed no significant difference. Weight reduction after lyophilization of human femoral heads was between 7.6% and 41%. Further weight reduction occurred after lipid extraction (38.7%). Total weight loss was 56.9%. There was a significant influence of intraosseous lipid content on the rehydration capability. After lyophilization alone the rehydration weight after 8 hours was only 18.1%, whereas after lipid extraction the weight increase was 43% after 0.5 hours, 36.4% after 1 hour, 57.6% after 2 hours, 60% after 4 hours, and 92.7% after 8 hours.
Based on the presented data rehydration time of 0.5 hours seems to have no disadvantage compared to longer time periods concerning breaking strength. Therefore a longer intraoperative time period seems not to be necessary. This is of advantage for a possible secondary contamination while the allograft is rehydrated. Rehydration after lipid extraction is more effective than rehydration after lyophilization alone. However, the question whether lipid extraction alter bone stability has to be proved in further studies.
多项研究表明,冻干骨同种异体移植在植入前进行补液的必要性。本研究的目的是评估不同补液时间对人皮质冻干和γ射线辐照同种异体移植稳定性的影响、冻干骨的补液能力以及脂质提取对补液的影响。不同补液时间(0.5、1、2、4、8小时)后冻干辐照皮质骨的断裂强度无显著差异。人股骨头冻干后的重量减轻在7.6%至41%之间。脂质提取后进一步减重(38.7%)。总重量损失为56.9%。骨内脂质含量对补液能力有显著影响。仅冻干后8小时的补液重量仅为18.1%,而脂质提取后,0.5小时后重量增加43%,1小时后为36.4%,2小时后为57.6%,4小时后为60%,8小时后为92.7%。
根据所提供的数据,与较长时间相比,0.5小时的补液时间在断裂强度方面似乎没有劣势。因此,似乎没有必要延长术中时间。这对于同种异体移植补液时可能发生的二次污染是有利的。脂质提取后的补液比仅冻干后的补液更有效。然而,脂质提取是否会改变骨稳定性的问题必须在进一步的研究中得到证实。