بررسي هيستوپاتولوژيكي و پاراكلينيكي پيوند خودي استخوان اسفنجي و مغز استخوان جهت پركردن نقيصه استخواني

Histopathological and Paraclinical Study of Autogenous Cancellous Bone and Bone Marrow Grafting for Filling of Segmental Bone Defect

Objective: Bone defect that is created by trauma, fracture and tumor removal or cysts is a major problem in orthopaedic surgery. Cancellous bone autografts and recently bone marrow have been considered as a material for promoting bone formation. The purpose of this study was pathological and paraclinical evaluation of autogenous cancellous bone graft and autogenous bone marrow for filling a 2.5 cm segmental bony defect. Materials and Methods: Fifteen adult dogs with an average age of 37.2 month and weight of 19.42 kg were surgically treated to create diaphyseal defects in the right ulna. The defects were filled with autogenous bone marrow in group 1, were grafted with autogenous cancellous bone in group 2 and were not filled in group 3 as control group. Cancellous bone was harvested from iliac crest by a chisel and a curret. Autogenous bone marrow was obtained by aspiration with a needle through the tip of the greater trochanter into the medullary canal of femur. The animals were under observation for 13 weeks and then euthinized and tissue sections prepared for pathological study. All the animals were followed paraclinically for 5 weeks. Results: The study showed no significant difference among three groups based on the parameters of R.B.C., P.C.V. and Hb. There was significant difference among three groups based on the parameters of W.B.C., neutrophil, lymphocyte, eosinophil, monocyte and band cells in all postoperative days. Calcium, phosphorous and magnesium showed no significant difference among three groups and among post and preoperative days. Alakaline phosphatase slightly increased after operation (that can be related to osteogenic activity of osteoblasts) but the difference among three groups and difference among post and preoperative days was not significant. In pathological assessment compact bone, mature haversian systems and a little spongy bone were observed in group 2. The similar results were observed in group 1, but the haversian systems were not mature as in group 2. New bone was formed by intramembraneous ossification in the cancellous bone group and by intramembraneous and endochondral ossification in the bone marrow group. Connective tissue and a little immature bone formation were observed in group 3. Conclusions: The results of this study showed that the autogenous bone marrow as well as cancellous bone graft can be used for filling segmental bone defect but the rate of osteogenesis is slightly lower.