Recep VURAL, Burak AKESEN, Mehmet KARAKAYALI, ÜLVİYE YALÇINKAYA, Ufuk AYDINLI

Otoklavizasyon ve pastörizasyonun kemik iyileflmesi üzerine olumsuz etkisinin karşılaştırılması

Amaç: Bu çal›flman›n amac› otoklavizasyon ve pastörizasyonun kemik iyileflmesi üzerine olan etkisini karfl›laflt›rmakt›r. Çal›flma plan›: Yetiflkin 25 tavflan çal›flmaya dahil edildi ve üç gruba ayr›ld›. Grup 1’de, ç›kar›- lan kemik bloklara otoklavizasyon uygulan›rken grup 2’de pastörizasyon ifllemi uyguland›. Grup 3’de ise kemik bloklara herhangi bir sterilizasyon ifllemi uygulanmad›. Sonuçlar: Heiple histolojik s›n›flamas›na göre, füzyon yüzeylerinin proksimal taraf›ndaki puan- lar; grup 1’de 12.8±0.4, grup 2’de 6.8±1.2 ve grup 3’de 10.2±1.9 idi. Füzyon yüzeylerinin distal taraf›ndaki puanlar ise bu gruplarda s›ras›yla, 10.8±0.8, 6.0±1.1 ve 9.8±1.5 idi. Üçüncü ve 6. haf- tada elde edilen radyografilere göre yap›lan füzyon de¤erlendirmesinde gruplar aras›nda fark saptanmad›. Ç›kar›mlar: Sonuç olarak, pastörizasyonun kemik iyileflmesi üzerine etkisi otoklavizasyon ile k›yasland›¤›nda daha azd›r ve uygun endikasyonlarda kemik sterilizasyonu için kullan›labilir.

___

1. Araki N, Myoui A, Kuratsu S, Hashimoto N, Inoue T, Kudawara I, et al. Intraoperative extracorporeal autoge- nous irradiated bone grafts in tumor surgery. Clin Orthop Relat Res 1999;(368):196-206.

2. Zoricic S, Bobinac D, Lah B, Maric I, Cvijanovic O, Bajek S, et al. Study of the healing process after transplantation of pasteurized bone grafts in rabbits. Acta Med Okayama 2002;56:121-8.

3. Kim HS, Kim KJ, Han I, Oh JH, Lee SH. The use of pas- teurized autologous grafts for periacetabular reconstruc- tion. Clin Orthop Relat Res 2007;464:217-23.

4. Uyttendaele D, De Schryver A, Claessens H, Roels H, Berkvens P, Mondelaers W. Limb conservation in primary bone tumours by resection, extracorporeal irradiation and re-implantation. J Bone Joint Surg Br 1988;70:348-53.

5. Ehara S, Nishida J, Shiraishi H, Tamakawa Y. Pasteurized intercalary autogenous bone graft: radiographic and scinti- graphic features. Skeletal Radiol 2000;29:335-9.

6. Manabe J. Experimental studies on pasteurized autoge- nous bone graft. [Article in Japanese] Nippon Seikeigeka Gakkai Zasshi 1993;67:255-66.

7. Izawa H, Hachiya Y, Kawai T, Muramatsu K, Narita Y, Ban N, et al. The effect of heat-treated human bone mor- phogenetic protein on clinical implantation. Clin Orthop Relat Res 2001;(390):252-8.

8. Hrapkiewicz K, Medina L, Holmes DD. Clinical medicine of small mammals and primates: an introduction. 2nd ed. London: Manson Publishing; 1998. p. 135-72.

9. Köhler P, Kreicbergs A. Incorporation of autoclaved auto- genic bone supplemented with allogenic demineralized bone matrix. An experimental study in the rabbit. Clin Orthop Relat Res 1987;(218):247-58.

10. Ahmed AR, Manabe J, Kawaguchi N, Matsumoto S, Matsushita Y. Radiographic analysis of pasteurized autol- ogous bone graft. Skeletal Radiol 2003;32:454-61.

11. Heiple KG, Chase SW, Herndon CH. A comparative study of the healing process following different types of bone transplantation. J Bone Joint Surg Am 1963;45:1593-616.

12. Lane JM, Sandhu HS. Current approaches to experimental bone grafting. Orthop Clin North Am 1987;18:213-25.

13. Harris IE, Leff AR, Gitelis S, Simon MA. Function after amputation, arthrodesis, or arthroplasty for tumors about the knee. J Bone Joint Surg Am 1990;72:1477-85.

14. Gitelis S, Piasecki P. Allograft prosthetic composite arthroplasty for osteosarcoma and other aggressive bone tumors. Clin Orthop Relat Res 1991;(270):197-201.

15. Cannon SR. Massive prostheses for malignant bone tumours of the limbs. J Bone Joint Surg Br 1997;79:497- 506.

16. Böhm P, Fritz J, Thiede S, Budach W. Reimplantation of extracorporeal irradiated bone segments in musculoskele- tal tumor surgery: clinical experience in eight patients and review of the literature. Langenbecks Arch Surg 2003; 387:355-65.

17. Köhler P, Kreickbergs A, Strömberg L. Physical proper- ties of autoclaved bone. Torsion test of rabbit diaphyseal bone. Acta Orthop Scand 1986;57:141-5.