It is very difficult to repair large articular cartilage defect of the hip. From May 1990 to April 1994, 47 hips in 42 patients of large articuler cartilage defects were repaired by allograft of skull periosteum. Among them, 14 cases, whose femoral heads were grade. IV necrosis, were given deep iliac circumflex artery pedicled iliac bone graft simultaneously. The skull periosteum had been treated by low tempreturel (-40 degrees C) before and kept in Nitrogen (-196 degrees C) till use. During the operation, the skull periosteum was sutured tightly to the femoral head and sticked to the accetabulum by medical ZT glue. Thirty eight hips in 34 patients were followed up for 2-6 years with an average of 3.4 years. According to the hip postoperative criteria of Wu Zhi-kang, 25 cases were excellent, 5 cases very good, 3 cases good and 1 case fair. The mean score increased from 6.4 before operation to 15.8 after operation. The results showed, in compare with autograft of periosteum for biological resurface of large articular defect, this method is free of donor-site morbidity. Skull periosteum allograft was effective for the treatment of large articular cartilage defects in hip.
To observe the effect of allogenic transplantation of deep frozen nerve in repairing sensory nerve defect, 22 patients who had received this type of treatment were followed up for 0.5-5 years. There were 18 males and 4 females in this group, and the average age was 28 years old. Thirty-six nerve defects including the common volar digital nerve, proper volar digital nerve were repaired by allograft of nerves stored at deep frozen (-80 degrees C). The storation period was ranged from 9 days to 1 years. The length of the nerves were 2 cm-12 cm. After follow-up for 3 years (ranged from 7 months-5 years), 23 cases of nerve allograft obtained excellent and good results (63.9%), 10 cases were fair (27.7%) and 3 cases were poor (8.3%). It was concluded that (1) frozen nerve is one of nice materials for repairing the nerve defect (lt; 5 cm); (2) the immunity of allogenenic nerve is weak; (3) the deep frozen storation can reduce the immunity of nerve; (4) the dimethyl sulfoxide can prevent the nerve tissue from injury by deep frozen; (5) the best temperature and period for deep frozen storation should be studied further.
Abstract In order to repair the bone defect afteroperation of benign lesion of extremity, the fetal demineralized bone was applied in 10 cases. These cases were followed up for 6 months to 8 years. The results showed that the grafted bone was integrated with the host bone in 6 months. Noadverse effect was found. The demineralized bone did not induce rejection. The advantages of using fetal demineralized bone were as follows: easily obtainable,its preparation and method of storage simple, and low finacial cast.
OBJECTIVE To explore the healing mechanism of full-thickness wound treating by the intermingled skin transplantation of large sheet allograft with autograft through studying the expression of laminin (LN). METHODS Thirty-six SD rats with 10% to 15% of total body surface area (TBSA) full-thickness were made. After 3 days, the devitalized tissue were excised and transplanted a large sheet of allograft from Wistar rats and islets of autografts were implanted 3 days later. On day 3, 5, 7, 14, 21 after allografting, the expression of LN in the grafts were detected by immunohistochemistry. RESULTS On the 7th day postallografting, LN, which played positive action of epidermal cell adhesion, still retained in the allodermis after the rejection of alloepidermis occurred. On the 14th day postallografting, there appeared scattered LN underneath the epidermal cells migrating from islets of autografts. On the 21st day postallografting, LN in the basement membrane of skin grafts had completely formed. CONCLUSION The intermingled transplantation of large sheet allograft with autograft may provide components of basement membrane for wound healing, which may help to improve the appearance and function of skin.
Objective To investigate the result of the transplantation of frozen canine phalangeal joint allografts perforated and incorporated with autogenic bone marrow. Methods A proximal interphalangeal joint defect of 1.5 cm was prepared at bilateral sides of twenty-four adult healthy out-bred dogs. Three different types of allografts were applied to repair the defects: fresh autogenic phalangeal joints (group A,n=16), frozen phalangeal joint allografts perforated and incorporated with fresh autogenic bone marrow(group B, n=16), and frozen phalangeal joint allografts(group C, n=16). Radiographic and histological study wereused to evaluate the survival of transplanted joints. The observation was done 1, 3, 6 and 12 months after operation respectively. Results Based on the radiographic and histological changes of the transplanted joints, the osteoarthropathy of transplanted canine phalangeal joints could be divided into 3 degrees: mild degeneration, moderate degeneration and severe degeneration. Mild degeneration was observed in group A from 3 to 12 months. Mild degeneration was also found in group B from 1 to 6 months, and the endochondral ossification was obvious within the drilled bony holes.However, some joints in group B underwent moderate degeneration 12 months after operation. Group C joints in the first month had moderate degeneration, which progressed to severe egeneration 3 months after operation. Conclusion Transplantation of frozen canine phalangeal joint allografts perforated and incorporated with autogenic bone marrow can effectively delay the degeneration of transplanted osteoarticular allografts at the early and middle stage.
Objective To evaluate the feasibility of preservation of arteriesby vitrification and the effectiveness of vitrified arteries as allografts. Methods Sixty rabbits were used in the research. Forty-eight femoral arteries wereharvested from 24 rabbits as the transplanted materials，and 24 femoral arteries were preserved by vitrification, 24 by freezing for 14 days，respectively. Theother 36 rabbits were used as the transplanted subjects，and were divided into three groups， 12 rabbits including 24 femoral arteries per group: Group A(fresharterial autografts), Group B(vitrified arterial allografts) and Group C(frozen arterial allografts). The morphologic changes of arterial grafts were observed macroscopically and histologically. The patent rate of arterial grafts were measured by angiography, and the rabbits were sacrificed on the 14th day, the 30th day, the 60th day and the 120th day after transplantation respectively. Arterial grafts were harvested to observe the morphological changes，and the immunological rejection was evaluated by measuring the ratio of tunica intima and tunica media. The results were compared between these groups. Results Before transplantation，theintegrated rate of Group B was 91.67%，which was significantly better than that of Group C（54.17%, Plt;0.01）. After transplantation, the accumulative patent rate of Group B was 87.50%，which was significantly better than that of Group C（66.67%, Plt;0.05）. There was statistically significant difference in the ratioof tunica intima and tunica media between Group B and Groups A, C（Plt;0.05）.Conclusion The above results show that vitrification does less damage to cells and tissues because of ice-free in the process of cryopreservation. So vitrification can be used to preserve arteries， and the arterial allografts preserved by vitrification are better than those preserved by freezing.
Objective To study the relation between changes of the hepatic energy metabolism and allograft viability in early phase after orthotopic liver transplantation, arterial blood ketone body ratio (AKBR) was measured in pre- intra and post-operative phase. Methods The monkeys were divided into two groups in accordance with survived times. A group (＞24h), 5 monkeys survived 29—168 postoperative hours; B group (＜24h), 9 monkeys survived only 5—22 hours. Results AKBR in all models immediately decreased to extraordinarily low state in anhepatic-phase (versus preanhepatic phase, Ｐ＜0.01), and A group recovered rapidly to the normal levels, and maintained continuously for 12 postoperative hours above the level of 0.7. In contrast in B group, AKBR decreased below 0.7 rapidly and failed to restore to the normal level. Within 12 hours postoperatively, in B group, AKBR was lower than 0.4. Conclusion AKBR is a sensitve indicator to the allograft viability in the early phase after hepatic transplantation.
The canine saphaneous skin flap was used as a model in this experiment. The cutaneous autograft would give long-term survival, whereas the allograft without pretreatment would only survive 10. 2±1.9 days from its transplantation. If the pretreatment consisted of the use of immunosuppressive agent as PHA or infusion of dexamesone, the survival days of the allografts could be prolonged to 15.1±2.5 and 13.7±2.8, respectively(Plt;0.01). The histological examination gave the evidence that drug perfusion delayed the rejection.
ObjectiveTo review the research progress and clinical application of allograft bone spacer in cervical and lumbar interbody fusion. MethodsLiterature about allograft bone spacer in cervical and lumbar degenerative disease was reviewed and analyzed, including the advantages and disadvantages of allograft material, fusion rate, effectiveness, and complications. ResultsFusion rate and effectiveness of allograft bone spacers were similar to those of autograft and polyetheretherketone spacers, and they were recommended by many orthopedists. However, indications, long-term effectiveness, and complications were not clear. ConclusionFurther study on allograft bone spacer in cervical and lumbar interbody fusion should be focused on optimal indications and long-term effectiveness.
fter total hip replacement ,massive bone defect occured freqently due to wearing and loosening of the prcathesis.The use of deep-freezing allograft to su pport a new implant was an attractive solution. Deep-freezing decreased the immune antigenicity of the transplanted allograft.From 1972 to 1990. the deep-freezing allografts were used in rcvision total hip replacement in 212 cases,in which 187 cases(198 hips) were followed-up for over 1 year.The general effective rate was 85%....