| Bone transplantation is one of the fundamental measures in the treatment of bone nonunion and bone defect. The research of ideal bone transplantation material is one important topic in orthopaedics. Transplantation of bone xenograft is an important issue in orthopaedic field. The main problem in this research field is how to keep its capability of bone induction when materials, which could cause immune rejection, are being eliminated. At the beginning of 1990s, reconstitued bone xenograft (RBX) was invented by our institute. It was proved of nice bone inductive capability with no obvious rejection after long time animal experiment and primary clinical application. In order to estimate the clinical effect and security of RBX, cases with long bone nonunion that had been treated in the past 11 years in Xijing Hospital had been followed up. The clinical effect of using different kind of bone transplantation materials had been compared. Skin incisions after the operation of RBX transplantation and the changes of immunological index at different time before and after operation had been observed to estimate the security of RBX.Because there are much more (255) cases with long bone nonunion, case-information-database had been established in this research through database-manager-system (DBMS) to collect related case information. The data were managed by related analysis at the end of the research. The establishment of this database had supplied much convenient and had saved much time in the research. This also facilitated the looking and proving of original materials.This research mainly analyzed the affect on the union rate of long bone nonuinon with different kind of bone transplantation. In this research, 69 cases used RBX transplantation, 87 cases used autogenous bone (AU), respectively. 74 cases used autogenous bone and RBX together. The union rate of the three groups is 97.1%, 96.6% and 93.2%, respectively. The data of every two groups among the three groups were contrasted. The following are the results after statistical analysis. RBX: AU+RBX, p=0.496>0.05. RBX:AU, p=1.00>0.05. AU+RBX:AU, p=0.549>0.05. The result showed that there had no obvious difference between each two group. In order to exclude the affect of internal fixation on the result of treatment, cases (122 cases) in the three groups using steel plate fixation had been contrasted. 27 cases used RBX, 37 cases used autogenous bone, respectively. 58 cases used autogenous bone and RBX together. The union rate of the three groups is 92.6%, 94.6% and 94.8%, respectively. The data of every two groups among the three groups were also contrasted and the following is the result after statistical analysis. RBX:AU+RBX, p=1.00>0.05. RBX:AU, p=1.00>0.05. AU+RBX:AU, p=1.00>0.05. The result showed that there had no obvious difference between each two group, either.In this research, the incisions of the cases with RBX transplantation were healed primarily. Nine cases in this research had used anti-infectious RBX (ARBX) for having infectious bone nonunion before bone transplantation. This research had also proved the anti-infection effect of ARBX.Immunological index of periphery blood of 49 cases with RBX transplantation had been detected before operation and at the first, second and the fourth week after operation. The index of each case before operation had been contrasted with the indexes that were detected at different time point after operation, respectively, using paired test (self contrast). The result showed that the immunological index before operation had no obvious difference with that were detected at different time points after operation.The results in this research prove that RBX is safe and effective in the treatment of long bone nonuion without immune rejection. This had established the bases for the clinical extending of RBX in the future. The analysis of the reasons of long bone nonuion and their fixation methods had summarized much experience for its prophylaxis and treatment. Conclusion1. RBX could be u... |
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