Experimental study for vascularized bone graft with tissue engineering technique

带血管蒂骨移植骨缺损区与非血管化游离骨瓣相比有许多优点，但这些移植物的可用性极其有限。吻合血管的移植骨直径较小，会导致骨折等并发症。髂骨和胫骨近端的肿瘤植骨是预防带血管蒂骨骨折的临床途径之一。但这些方法都受到供体部位体积的限制。近年来，组织工程骨技术得到了发展和临床应用的报道。组织工程骨被放置在哪里并没有很好的记录。本研究的目的是观察F344大鼠带血管蒂骨膜下或骨膜上移植的组织工程骨的组织学和X线表现。将组织工程骨植入胫骨前段骨膜下或骨膜上方。CT扫描12个月后，移植骨强度增加至皮质骨水平，18个月后保持不变。骨膜下组骨膜右侧有皮质骨结构。提示骨膜下组织工程骨移植分为皮质骨和增加血管化移植骨体积的方法之一。

Skeletal bone defects with vascularized bone grafts has many advantages over non vascularized free grafts, but the availability of these grafts is extremely limited. Less of diameter in vascularized grafted bone caused several complication such as bone fracture. Cancelous bone graft from iliac bone and proximal of tibia were one of the clinical approach for prevent fractures of vascularized bone. but these methods has limitation of volume by donor site. Recently tissue engineered bone technique were developed and reported for clinical applications. Where the tissue engineered bone is placed is not well documented. The purpose of this study was to examine the histology and radiography of tissue engineered bone grafted under vascularized periosteum or over periosteum in F344 rats. Tissue engineered bone were placed in under or over periosteum of anterior tibia. In computed tomography, after 12 months, intensity of grafted bone increase to cortical level and maintain same intensity of cortical bone after 18 months. In under periosteum group, there were cortical bone structure right on the periosteum. the findings suggest that tissue engineered bone grafted under periosteum were divided to cortical bone and one of the method of increase the volume of vascuiarized grafted bone.