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同种异体骨软骨移植重建膝关节表面。33例临床分析。

Osteochondral resurfacing of the knee joint with allograft. Clinical analysis of 33 cases.

作者信息

Bakay A, Csönge L, Papp G, Fekete L

机构信息

MAV Hospital, Department of Traumatology, Budapest, Hungary.

出版信息

Int Orthop. 1998;22(5):277-81. doi: 10.1007/s002640050260.

Abstract

This retrospective clinical study describes three years of experience with cryoprotected-cryopreserved allograft transplantation. During this period 33 knee joints were operated on for different reasons including osteoarthritis, osteochondritis dissecans and post-traumatic surface irregularity. The mean follow-up was nearly two years and the mean age of the patients was 48 years. The grafts were harvested and processed at the West Hungarian Tissue Bank according to the criteria promulgated by the European Association of Tissue Banks. All the operations were performed in the same way. Three types of grafts were used: cylindrical or mushroom-shaped for the femoral condyle and patellar and shell allografts for resurfacing the tibial plateau. Bone matrix gelatine (BMG) and fibrin sealant (Tissucol) were used locally to enhance the revascularisation and to improve the decreased osteoinductivity of the frozen cancellous bone. According to the modified Bentley score, the success rate of the short term follow-up was similar to that of other reported series. An analysis of four biopsies showed that the BMG and fibrin sealant did not appear to affect the viability of the articular cartilage. We conclude that application of these materials is not contra-indicated in allograft surgery.

摘要

这项回顾性临床研究描述了三年来使用冷冻保护-冷冻保存同种异体移植的经验。在此期间,因不同原因对33个膝关节进行了手术,包括骨关节炎、剥脱性骨软骨炎和创伤后表面不平整。平均随访时间近两年,患者平均年龄为48岁。移植物在匈牙利西部组织库按照欧洲组织库协会颁布的标准进行采集和处理。所有手术均以相同方式进行。使用了三种类型的移植物:用于股骨髁和髌骨的圆柱形或蘑菇形移植物,以及用于胫骨平台表面置换的壳状同种异体移植物。局部使用骨基质明胶(BMG)和纤维蛋白密封剂(Tissucol)以促进血管再生并改善冷冻松质骨降低的骨诱导性。根据改良的本特利评分,短期随访的成功率与其他报道系列相似。对四次活检的分析表明,BMG和纤维蛋白密封剂似乎并未影响关节软骨的活力。我们得出结论,在同种异体移植手术中应用这些材料并无禁忌。

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