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.
Objective To explore the clinical application of allogeneic tendonhandled by ultra-deep-low-temperature. Methods From March 1995 to June 2002，tendons rupture and tendons defect were repaired by ultra-deep-low-temperatureallogeneic tendon grafts in 96 cases, including 51 cases of flexor or extensor tendon defect of hand, 36 cases of coracoclariculare ligament rupture, 4 cases of cruciate ligament rupture, 2 cases of calcaneus tendon rupture and 3 cases ofextensor tendon defect of foot. The interval between injury and operation was 1day to 5 months. The length of defect was 4-12 cm with an average of 7 cm.The matching allogeneic tendons were selected during operation, and early function exercise was done after operation. Secondary release was performed in the cases of tendon adhesion.Results Follow-up time is from 6 months to 5 years (3.4 years on average). No rejection or rupture occurred after tendon allograft. The satisfactory result was achieved in 92.71% of the cases. Conclusion The allogeneic tendon is similar to auto-tendon in transplanting, healing and function is useful clinically.
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.
Objective To investigate effect of the removal of epithelium and mixed glands from the tracheal allografts on the graftimmunosuppression. Methods Fresh untreated tracheal allografts， cryopreserved tracheal allografts, and 10 off-epithelium tracheal allografts were obtained from 25 male SD rats. Fresh untreated tracheal allografts(40) were divided into 4 groups and dipped respectively in the solution of protease ⅩⅣ in 0, 0.1, 0.3 and 0.5 mg/ml at 4℃ for 12 hours. Thirty recipient male SD rats were randomly and equally divided into group A (fresh untreated tracheal allografts), group B(cryopreserved tracheal allografts), and group C(offepithelium tracheal allografts). The transplanted allografts were implanted into the abdominal cavity of other rats by being embedded in the greater omentum. Twenty-one days after transplantation, the tracheal graft segments were surgically removed, and then were initially fixed in cold 10% neutral buffered formalin solution for hematoxylineosin staining. Histological observation and lymphocyte infiltration were performed on the grafts to evaluate rejection. Results The 0.3 mg/ml protease ⅩⅣ could remove the epithelium and mixed glands of the grafts completely, but did no damage to cartilage. The cartilages of each group all survived and were revascularized. The lumens of group A were filled with granulation and necrosis tissue. In contrast, group B was filled with a few granulation tissues and group C was not at all. The number of lymphocyte infiltration in group A, B, and C was 29.16±2.69/HP, 15.17±2.19/HP, and 11.56±0.87/HP respectively. There was significant difference between group A and both group B and group C (Plt;0.05), and there was significant difference between group B and group C (Plt;0.05). Therefore, the grade of graftrejectionwas group Agt;group Bgt;group C. Conclusion The 0.3 mg/ml protease ⅩⅣ can completely remove the epithelium and mixed glands of grafts at 4℃ for 12 hours, and it preserves the normal structure of cartilage. The antigenicity of tracheal grafts can be greatly reduced by removing the epithelium and by the cryopreservation. The prior tracheal allograft in the omentum is feasible for the revascularization of the grafts.
Objective To explore an effective way fortreating severe complicated distal femoral fractures. Methods Twenty-six patients with complicated distal femoral fracture who all belonged to 33C3.3type according to AO/ASIF lassification, were treated with a lateral condylar buttress plate or self-desinged aliform anatomical plate, and operated on with allogeneic bone grafting. Results All cases were followed up for an average of 14 months (ranging 5-25 months). Twenty-four wounds were primary healing postoperatively, 2 wounds were infected and healed after dressing change. Twenty-four had bone healing after 411 months, 2 needed to operate again because of earlier weight-bearing resulting in fixation failure. According to shelbourne and Brueckmann score, the excellent and good rate was 88.46%. Conclusion The internal fixation forcomplicated distal femoral fracture by self-designed aliform anatomical plate and lateral condylar buttress plate with a great deal of allograft bone is an effective surgical method. As it has long oval holes and the holes are consecutive ,the aliform anatomical plate is more suitable for severe complicated fractures. At the same time, autogenous-ilium transplantation can be substituted by the allograft bone.
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.
Abstract In order to determine the fasibility of reestablishment of circulation with cryopreserved microvenous allografts (1.0～1.4mm in diameter), 40 rabbits were divided into 2 groups. In the control group, the fresh autografts were used. In the experimental group, 20 rabbitsfemoral vein segments were treated by a two-step freezing procedure. After stored in liquid nitrogen for 48 hours, the segments were implanted into the femoral veins as allografts. The histological as well as the pathological studies were performed with light and electron microscope, and its patency was determined by angiography. The results showed that the preservation of vein was generally good. The rejective response was weak. The patency rates of 1 week and 12 weeks were 90% and 85% respectively, and there was no significant difference with that of the allogenic fresh autografts (Pgt;0.05). It was suggested that clinical use of cryoperserved allogenic microvein grafts instead of fresh autografts was possible.
Objective To evaluate the feasibil ity and effectiveness of allograft osteochondral transplantation with arthroscopic assistance for osteochondritis dissecans (OCD) associated with large osteochondral defects. Methods From January 2004 to May 2007, 13 patients with OCD with large osteochondral defects were treated. There were 7 males and 6 females, aged 18-59 years with an average of 35.8 years. The locations were left side in 8 cases and right side in 5 cases. The disease course was 7 days to 20 years with the median duration of 42 months. Four cases had obvious sprained history. The involved locations were lateral portion of the medial femur condyle (MFC) in 5 cases, thochlea area of MFC in 2 cases and lateral femur condyle in 6 cases. The range of motion was (95.0 ± 13.5)° and the Lysholm score was 62.23 ± 7.79. According to International Cartilage Repair Society classification system and the Guhl classification of OCD under arthroscopy, all the patients were type IV. Defect areas were 3-7 cm2 with an average of 4.32 cm2. The depths of defects were 0.8-2.0 cm with an average of 1.55 cm. Allograft osteochondral transplantation combining with adsorbable screw was appl ied for the lesions. The patients were closely instructed to do exercise through following up. Results The wounds all healed by first intention Thirteen cases were followed up for 2.2 years (14 months to 4 years) after operation. Three months after operation, 2 cases had pain after continuous exercise for 1 hour, they were directed in the methods of functional exercise and to strengthen their quadriceps femoris. Medicine was given in 2 patients who had sign of friction feel ing of joint 6 months after operation. The range of motion at the last follow-up was (137.0 ± 9.8)°, showing statistically significant difference when compared with that before operation (P lt; 0.05). The X-rays and EMRI examinations at following-up indicated that bone healed well and articular facet was integrity. The Lysholm score was 92.08 ± 7.64 one year after operation, showing statistically significant difference when compared with that before operation (P lt; 0.05). Conclusion Allograft osteochondral transplantation with arthroscopic assistance is a useful method in treatment of OCD with large osteochondral defects of the knees.
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%....