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미성숙 돼지 대퇴골두 무혈성 괴사에서 괴사부 절제 및 DBM-CaSO4 이식효과

Other Titles
 Effect of Curettage and DBM-CaSO4 Graft for the Treatment of Ischemic Necrosis of the Capital Femoral Epiphysis in Immature Pigs 
 이기석  ;  김선용  ;  최인호 
 Journal of Korean Orthopaedic Research Society (대한정형외과연구학회지), Vol.13(2) : 68-79, 2010 
Journal Title
Journal of Korean Orthopaedic Research Society(대한정형외과연구학회지)
Issue Date
Legg-Calve′-Perthes disease ; Ischemic necrosis ; Capital femoral epiphysis ; Curettage ; Demineralized bone matrix (DBM)
Purpose: The purpose of this study was to determine the effect of curettage and DBM complex graft as a new
treatment modality for LCP disease using piglet capital femoral epiphysis ischemic necrosis model.
Materials and Methods: Five to six weeks old piglets were used for the experiment. Ischemic necrosis of the
capital femoral epiphysis was surgically induced by cervical ligation on both sides. Three weeks following
ischemic insult, the left hip joint was approached medially. About 15% of the necrotic capital femoral epiphysis
was curetted through a window which was opened at medial cervical cortex, then, demineralized bone matrix
complex was engrafted. The right femoral heads served as controls. Piglets were sacrificed three, six, nine, and
twelve weeks following were harvested for histologic examination.
Results: In control group, photomicrographs of specimens showed central necrosis and fibrovascular invasion
in capital femoral necrosis at three weeks after ischemic insult. Six, nine, and twelve weeks following ischemic
insult, fibrovascular invasion advanced without noticeable new bone formation and collapse of femoral head progressed
. At twelve weeks, definite coxa plana developed. In curettage and DBM complex graft group, there was
evident new bone formation observed in the site of DBM complex graft. At three weeks, new bone formation
along with fibrovascular invasion was observed around the engrafted DBM complex mainly in the cervical metaphyseal
area. At six and nine weeks, new bone formation progressed into the engrafted DBM complex in the cervical
metaphysis and around the engrafted DBM complex in the capital femoral epiphysis. At twelve weeks, new
bone along with new cartilage formation was observed in the capital femoral epiphysis.
Conclusion: In conclusion, curettage and DBM complex graft is thought to be an effective treatment modality
that promote regeneration of ischemic necrosis of capital femoral epiphysis
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Ki Seok(이기석)
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