vascularized osteo-periosteal grafts prefabricated by applying BMP on the periosteum.

在大鼠胫骨内侧建立带血管蒂骨膜瓣，观察骨膜成骨能力及骨形态发生蛋白（BMP）对其成骨的影响。材料与方法：对大鼠胫骨内侧骨膜进行了解剖学观察，发现骨膜有股血管分支之一的隐动静脉营养。在手术显微镜下从胫骨上剥离骨膜。植入的BMP总量为10 μ g，并且使用新开发的合成可吸收聚-D，L-乳酸聚乙二醇（PLA-PEG）嵌段共聚物作为BMP载体。将大鼠分为四组，并在每组中进行以下程序。第1组仅抬高骨膜，立即闭合皮肤。将不含BMP的PLA-PEG植入骨膜间 关于我们 第2组为股骨和胫骨。在第3组中，将骨膜抬起，并将含有BMP的PLA-PEG置于骨膜和胫骨之间。第4组将含有BMP的PLA-PEG植入骨膜。术后3周取出胫骨，并通过组织学和X线片检查新骨形成的量。结果：第1组和第2组在组织学上可见少量新生骨。第3组沿着有一定数量的新骨形成，并伴有骨膜增厚。另一方面，在第4组中，几乎没有骨形成或骨膜增厚。结论：单纯骨膜剥离后，骨膜具有生成骨组织的能力。然而，形成的骨量很小，似乎不足以转移到骨缺损中。骨形态发生蛋白植入胫骨与骨膜之间，刺激骨膜，3周内显示出广泛的成骨作用。由BMIP刺激的骨膜形成的骨似乎足够好，可以作为血管化预制骨-骨膜移植物转移，其将在隐血管或股骨血管上升高，并作为带蒂或游离移植物移植到股骨或胫骨的骨缺损中。少

The vascularized periosteal flap was raised on the medial side of the rat tibia in order to investigate the osteogenetic ability of the periosteum and the effect of a bone morphogentic protein (BMP) on its osteogenesis. Materials and Methods : The periosteum on the medical aspect of the rat tibia was anatomically dissected and the periosteum was found to be nourished by the saphenous artery and veins, which was one of the branches of the femoral vessels. The periosteum was disseced from the tibia under an operating microscope. The amount of the BMP implanted was 10 mug in total, and a newly developed, synthetic absorbable poly-D,L-lactic acid polyethylene glycol (PLA-PEG) block copolymers was used as a BMP-carrier. The rats were divided into four groups and the following procedures were performed in each group. The periosteum was just raised and the skin was closed immediately in Group 1. The periosteum was raised and the PLA-PEG not containing the BMP was implanted between the periost … More eum and tibia in Group 2. The periosteum was raised and the PLA-PEG containing the BMP was placed between the periosteum and tibia in Group 3. The PLA-PEG containing the BMP was implanted on the periosteum in Group 4. The tibia was removed three weeks postoperatively and the amount of the new bone formation was examined histologically and by radiographs as well. Results : A small amount of new bone was seen histologically in Group 1 and 2. A definite and relatively a large amount of new bone was formed in Group 3 along with a periosteal thickening. In Group 4, on the other hand, there was little bone formation or periosteal thickening. Conclusions : The periosteum proved to have an ability to generate bone tissue after a periosteal stripping alone. The amount of bone formed was, however, small and appeared not enough to be transferred into bony defects. The periosteum stimulated by the BMP implanted between the tibia and periosteum exhibited an extensive osteogenesis in three weeks. The bone formed by the BMIP-stimulated periosteum appeared good enough to be transferred as a vascularized prefabricated osteo-periosteal graft, which was to be raised on the saphenous or femoral vessels and grafted as a pedicled or free graft into a bony defect in the femur or tibia. Less