Tissue reaction of bone inductive hydroxyapatite cement and its clinical opplication.

1. 我们将羟基磷灰石（HA）骨水泥植入20只家兔胫骨骨干。术后1周、3周、6周、12周分别处死5只家兔，制作3组未变性胫骨标本。标本用甲苯胺蓝染色，在光镜下观察。采用半自动组织形态测量仪（Affinity Index）对新生骨组织进行定量评价。在3周后的所有标本中，观察到新骨与HA水泥表面结合。亲和性指数越晚越高。综上所述，在HA水泥周围观察到良好的骨导电性。今后，我们打算在长期检查中进行评价。直到1998年，我们使用羟基磷灰石块对9个膝关节进行了开放楔形胫骨高位截骨术，我们在本研究中调查了这些病例的结果。临床症状明显改善，x线片未见羟基磷灰石块宏观骨折。股骨胫骨角在手术中保持相同的角度。然而，需要更长期的随访研究来确定该手术的结果。未钙化切片是在手术后1年取出内固定物时从种植体表面取出的标本制备的。组织学未见炎症反应，未见纤维组织包封，骨植入物直接植入。羟基磷灰石块孔内可见骨长入，与术后2 ~ 3年标本比较。

1. We implanted hydroxyapatite(HA) cement into the diaphysis of tibia of 20 rabbits. Five rabbits were killed 1, 3, 6 and 12 weeks after the operation, and a series of three undecalsified specimens of tibia was made. The specimens were stained with toluidine blue and observed under a light microscopy. Quantitative evaluation for newly developed bony tissue was performed with the semiautomatic machine for histomorphometry (Affinity Index). In all specimens after 3 weeks, new bone bonded to the surface of the HA cement was observed. Affinity Index was higher in later groups. Taken together, good osteoconductivity was observed around HA cement. Hereafter, we intend to evaluate in long term examination.2. Opening wedge high tibial osteotomy was performed in 9 knees using Hydroxyapatite block until 1998, and we investigated results of these cases in this study. Clinical sympton was significantly improved, and macroscopic fracture of hydroxyapatite block was not observed in radiograms. Femorotibial angle remained same angle corrected in operation. However, longer term follow up study should be required to determine the result of this procedure. Undecalcified sections were prepared from specimens taken from the surface of implants at removal of internal fixation performed 1 year after operation. Histological appearance showed no inflammatory reaction, and direct bone-implant incorporation without fibrous tissue encapsulation was observed. Bone ingrowth was observed in the pores of the hydroxyapatite block, and the results should be compared with that of specimens taken 2 or 3 years after operation.