Cornu O H, de Halleux J, Banse X, Delloye C
Department of Orthopaedic Surgery, Catholic University of Louvain, St Luc University Clinics, Brussels, Belgium.
Arch Orthop Trauma Surg. 1995;114(6):324-9. doi: 10.1007/BF00448955.
We retrospectively investigated the fate of bone auto- and allografts in 64 patients who underwent a tibial tubercle elevation with bone graft. Half of them received an autograft and the other half, an allograft that had been processed and freeze-dried. The two groups had similar preoperative characteristics concerning age, sex and pathology. Roentgenograms were reviewed by three independent observers and scored for fusion, resorption and collapse. Clinical charts were analysed for different variables. The overall radiological score for both groups did not differ statistically. Comparison of graft fixation with one or two screws demonstrated more bone resorption in the case of a single-screw fixation. In such a case, the occurrence of a preoperative tubercle fracture had a significant adverse influence, due to a less stable fixation. From the clinical charts review, only the mean stay at hospital was significantly shorter when an allograft was performed. A bone allograft appears to be suitable to maintain an osteotomy but requires a more careful surgical technique fixation to obtain a similar result to an autograft.
我们回顾性研究了64例行胫骨结节抬高植骨术患者的自体骨和同种异体骨移植转归情况。其中一半患者接受自体骨移植，另一半接受经过处理和冻干的同种异体骨移植。两组患者在年龄、性别和病理方面术前特征相似。三位独立观察者对X线片进行评估，并对融合、吸收和塌陷情况进行评分。分析临床病历中的不同变量。两组的总体放射学评分无统计学差异。比较单枚螺钉和双枚螺钉固定移植物的情况，单枚螺钉固定时骨吸收更多。在这种情况下，术前结节骨折的发生会产生显著的不利影响，因为固定稳定性较差。从临床病历回顾来看，仅同种异体骨移植时平均住院时间显著更短。同种异体骨似乎适合维持截骨，但需要更精细的手术技术固定，以获得与自体骨相似的结果。
