The Sartorius Musclar Iliac Flap Repairing Segmental Acetabular Bone Defects In The Total Hip Replacement Of Goats

BackgroundAt present,acetabular bone deficiency is augmented increasingly,it become a formidable tough problem clinically.Bone transplantation is one of necessary means which repair bone defects.Before,bone defects was repaired by xenogeneic bone transplantation,allogenic bone transplantation,autologous free bone transplantation in the clinical.But the long-term effect is very bad.At home professor Wang et al adopted successfully a new means that the sartorius musclar iliac flap repairing segmental acetabular bone defects in total hip replacement,and gained satisfactory follow up result.The bone graft way is autologous living bone transplantation of existing blood supply,to be provided with three biology functions of bone conduction,bone induction,bone formation,it strengthen materially bone formation effective.The purpose of the study is to establish a goat model on the foundation that autologous living bone transplantation successful repairing segmental acetabular bone defects on clinic,then,using the goats sartorius musclar iliac flap living bone transplantation and autologous dead bone transplantation repairing segmental acetabular bone defects,to observe imageology,histology,vitodynamics,and preliminary research the news operating way.Objective1. To design and manufacture hip prostheses for goats.2. To understand goats sartorius muscle iliac flap anatomy,observe its blood supply, certify similarity with the human and laying operative approach.3. To establish animal model of goats sartorius musclar iliac flap repairing segmental acetabular bone defects in total hip replacement(THR),and certify the reliability of the model.4. To compare the bone formation effect of sartorius musclar iliac flap and autologous iliac flap transplantation,thereby,supply some theory foundation for clinical.Methods1. Manufacture of hip prostheses for goats:diameters of femoral heads,lengths of femoral necks,widths of medullary cavity and inside diameter of acetabular bone of 10 goats were measured and averaged,hip prostheses for goats was design and manufactured.2. Dissecting goats sartorius muscle iliac flap:understand position,adjoin,courser,saliens punctum,insertion and nutrient vessel of goats sartorius muscle,observe its blood supply and limited length.3. Establishing animal model of goats:the segmental acetabular bone defects on superior weight loading area were made for 20 healthy 1～1.5 years goats in total hipreplacement,and they were randomly divided into two groups and divided into 4 weeks and 8 weeks:the control groups:the fresh autologous free iliac flap transplantation;the experimental groups:the autologous sartorius musclar iliac flap transplantation.4. Observing x-ray:the effect of bone transplantation repairing acetabular bone defects for the control and experimental groups were observed for postoperatively,4 weeks and 8 weeks.5. Observing histology:collect acetabular bone specimen that were observed on gross,hematoxylin and eosin dyeing (HE)and microvascular density(MVD)throughⅧfactor specificity marker vascular endothelial cell(VEC)on immunohistochemistry.6. Testing and measurement vitodynamics:the goats acetabular bone were carried out test of vitodynamics out-of-body that were simulate in corpore condition,and to observe the maximum load of the goats acetabular bone on two sets in THR.Results1. Manufacture of hip prostheses for goats:the artificial thigh bone of goats were successfully designed and made from titanium alloy with heads of 8mm,shaft of 6mm,7mm,8mm in diameters after parameters of goats'femurs were obtained.The prosthesis of acetabular bone was made from giant molecule polyethylene with its external diameter is 22mm.2. Blood supply of iliac flap is well,activity length of the sartorius musclar iliac flap is enough for repairing.3. After establishing animal model of goats,the goats'gait both two sets is nearly normal tend to normal by degrees under condition of affected limb weight loading,it is nearly normal 8weeks postoperatively.4. Osteotylus growth was not discovered obviously in x-ray 4 weeks ostoperatively on the control groups,fracture line was clear in it;a little osteotylus was discovered in x-ray on experimental the groups,fracture line was fuzzy in it;osteotylus was augmented in x-ray 8 weeks postoperatively on two sets,fracture line was nearly vanish in it and it was not significant difference.5. Observing histology:(1) Observing the specimen:slight fibrous granulation tissue and clear fracture line was discovered between parasitifer bone and bone graft 4 weeks postoperatively on the control groups. it was not significant difference 8 weeks postoperatively on two sets.slight osteotylus,fibrous granulation tissue and fuzzy fracture line was discovered between them on the control groups.it was not significant difference 8 weeks postoperatively on two sets.(2) Observing HE dyeing:4 weeks postoperatively,small amounts collagenoblast,bone trabecula,bone cell and small lumens of nascent micrangium were discovered in bony callus between parasitifer bone and bone graft,and bone resorption was discovered in bone graft on the control groups;ditissimus lumens of nascent micrangium,collagenoblast,bone cell in bone trabecula were discovered between them and the iliac flap can keep it's structure similar to cancellated bone on the experimental groups;8 weeks postoperatively,bone trabecula and bone cell were augmented,loose trabecular pattern,slight empty lacune and bone cell karyolysis were discovered in bone graft on the control groups;copious bone trabecula and bone cell in it,bone cell in bone trabecula were discovered between them and the iliac flap can keep it's structure similar to cancellated bone on the experimental groups.(3) MVD:Quantity of new vessels(NV)is more on the experimental groups than on the control groups durante bone healing(P <0.05).6. It was displayed that the maximum load of the goats acetabular bone had a descending tendency on the control groups on postop,and it had not nearly change on the experimental groups.The maximum load of the repaired acetabular bone had significant difference(P <0.05). Conclusion1. The hip prostheses for goats satisfy THR. Bone graft on weight loading area can bear heavy body under stress affect of goats artificial thigh bone. Bad consequence was not appear for suffering force.2. The goats sartorius muscle iliac flap exist definite blood supply,and have definite biological activity,belong to living bone transplantation.3. By X-ray,histology,vitodynamics means,the sartorius musclar iliac flap is outweigh free iliac bone on repairing segmental acetabular bone defects in the total hip replacement of goats 4 and 8 weeks postoperatively.