각종조직을 가토신장피막하(家兎腎臟被膜下)에 이식하였을때 생기는 골형성에 관한 연구

Abstract

[한글]

[영문]

Introduction

The source of new bone that results from various regenerative process in bone

grafts, and in particular, the orgin of new bone when osseous tissues are

transplanted into nonskeletal tissue, has been the subject of considerable interest

in recent orthopaedic literature.

The two theories of new bone formation are: 1) the osteoblastic therory proposed

by Ham (1930), and Urist and McLean(1941) which states that all new bone formation

results from osteoblasts which arise from living osseous structures such as

periosteum, endosteum, and connective tissue of the Haversian canal, either of the

host bone or of grafts, and 2) the metaplasia theory proposed by Baschkirzew and

Petrow(1912), and Levander(1938) which staes that an osteogenic substance, referred

to as an inducer or organizer which is present in the grafts, can cause indifferent

connective tissue cells to form osteoblasts which lay down new bone around bone

grafts.

Urist and McLean(1952) reported that their studies of osteogenetic tissues

transplanted into the anteiror chamber of the rabbit's eye, indicated that

periosteum, bone marrow, and some of the elements of cancellous bone and of

fibrocartilagenous callus might survive and proliferate following transplantation,

and give rise to new bone directly. They supported the osteoblastic theory.

De Bruyn and Kabisch(1955) transplanted various osseous tissues into the femoral

muscle of the rabbit. They reported that the new bone developed by metaplasia of

the connective tissue surrounding the transplants and thus they supported the

metaplasia theory.

The present investigation is concerned with the question whether new bone

formation by transplants originates from sepcific osteogenetic cells derived from

the transplants, or by a metaplastic process in the connective tissue surrounding

the transplant, under the influence of osteogenetic substances present in the

transplant. Observations were also made on the histological changes and the fate of

the transplants as well as the neighbouring connective tissue of the transplants.

Materials and Methods

Albino rabbits, weighing about 2 kg., were used throughout the experiment. The

autogenous transplants of the various tissues to be transferred were aseptically

removed under open drop ether anaesthesia and transplanted into the subcapsular

region of the kidney. For transplants, cortical bone and periosteum were taken from

the anterior portion of the tibia, muscle tissues taken from the quadriceps femoris

muscle, and hyaline cartilage and fibrocartilage taken from the costal cartilage

and the meniscus of the knee joint respectively. A small piece of gelfoam soaked in

a low concentration of chondroitin sulfate (Nutritional Biochemicals Corporation)

was also prepared for transplantation.

The transplants were kept in situ for periods of time varying from 2 to 20 weeks

after the transplantation. The transplants were removed with the surrounding

connective tissue and kidney, fixed in 10% formalin or Zenker's fixative,

decalcified in 5% nitric acid solution, and embedded in paraffin. The blocks were

serially sectioned 5 micra thick and the sections were stained with

hematoxylin-eosin.

Results

Group Ⅰ: Fresh autogenous cortical bone transplantation. The bone pieces

measured about 3x2x2 mm. were removed from the anterior portion of the tibia and

transplanted. Four weeks after the transplantation the peripheral portion of the

graft underwent certain degrees of the absorption and showed an uneven bone

surface. The lacunae of the central portion of the graft were empty and no living

osteocytes were observed in them. However, lacunae of the peripheral portion

containing living osteocytes were easily found. Evidence that the newly formed bone

was deposited on the surface of the graft, was observed. Eight weeks after the

transplantation, the original graft was found to be further replaced by the newly

formed bone and showed a more progressive absorption of the graft. In addition to

the progressive absorption, evidence of an intramembranous ossification near the

graft was confirmed. Twenty weeks following the transplantation, the most

peripheral portion of the graft was replaced by newly deposited bone in which a

Haversian system and newly organized red bone marrow were observed.조

Group Ⅱ: Boiled autogenous cortical bone transplant. The bone pieces, obtained a

s Group Ⅰ, were boiled in distilled water for 30 minutes before the

transplantation. After 4 weeks the lacunae were empty and no living osteocytes were

found in them. Bone absorption of the peripheral portion of the graft was observed,

accompanied by infiltration of probable osteoclasts or giant cells and a few

leucocytes in the surrounding connective tissue. There was no positive indication

of new bone formation. Eight weeks after the transplantation, the bone absorption

of the graft had progressed further. Also, new bone formation around or in the

graft was not found.

Group Ⅲ: Fresh autogenous periosteum transplantation. A small piece of

periosteum was carefully removed from the anterior portion of the tibia and grafted

into the subcapsular site of the host kidney. Four weeks after the transplantation,

newly formed bone embedded in the dense connective tissue, which might corresponded

to the grafted periosteum, was observed. After 8 weeks the bone formation had

progressed and a Haversian system was formed in the new bone.

Group Ⅳ: Fresh autogenous hyaline cartilage transplantation. A small piece of

hyaline cartilage, measuring about 3x2x2mm. in size, carefully obtained from the

costal cartilage, was grafted. Four weeks after the transplantation, the cartilage

showed certain degrees of absorption. However new bone formation around the grafted

cartilage was not observed. After 8 weeks the grafted cartilage showed entirely

empty lacunae and matrix was heavily calcified. The absorbed peripheral portion of

the graft showed new bone formation. The new bone formation was observed in the

area of the graft where the absorption of the cartilage took place.

Group Ⅴ: Fresh autogenous fibrocartilage transplantation. A small piece of

fibrocartilage(the same size as the hyaline cartilage) was obtained from the

meniscus of the knee joint and grafted. After 4 weeks there was no evidence of

production of newly formed bone around the graft. After 8 weeks the newly formed

bone had developed around the grafted fibrocartilage.

Group Ⅵ: Fresh autogenous uncrushed muscle tissue transplantation. A small piece

of skeletal muscle taken from the quadriceps femoris, was grafted. In no

experimental case of this group there was any evidence of new bone formation.

Group Ⅶ. Fresh autogenous crushed skeletal muscle transplantation. A small piece

of skeletal muscle taken from the same place as group Ⅵ, was crushed and grafted.

In these experimental cases the absorption of the grafted muscle tissue was more

rapid than in the cases of the Group Ⅵ. As in Group Ⅵ no evidence of new bone

formation was observed.

Group Ⅶ: Transplantation of gelfoam soaked in chondroitin sulfate. Six weeks

after the trasplantation, the grafts were completely absorbed without new bone

formation.

Summary

Observations were made on the incidence of bone formations as well as on the

histological processes involved in osteogenesis following the transplantation of

autogenous transplants of fresh cortical bone, boiled bone, fresh hyaline

cartilage, fibrocartilage, and skeletal muscle. In addition gelfoam containing

chondroitin sulfate was grafted and checked for new bone formation.

1) The author obserred new bone formation 4 weeks following transplantation of

autogenous fresh cortical bone and periosteum, and 8 weeks following

transplantation of autogenous fresh hyaline cartilage and fibrocartilage.

2) In the experiment of autogenous skeletal muscle and boiled cortical bone, no

evidence of new bone formation was found in the graft. Gelfoam with chondroitin

sulfate grafts were absorbed with no new bone formation.

3) Most of the transplanted bone underwent devitailzation and degeneration, and

subsequently bone formation and bone resorption which led eventually to complete

replacement of the original transplanted bone by new bone.

4) New bone formation observed in cases of fresh autogenous cortical bone and

periosteum transplantation indicates that it is directly derived from the grafts.

This supports the osteoblastic theory.

5) However, new bone formation observed in case of hyaline cartilage and

fibrocartilage is attributed to the mechanism of induction.