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Objective To understand the current status of surgical treatment for hemophilia osteoarthropathy (HO) in China. Methods Using an online questionnaire, select domestic hospitals that partici-pated in the compilation of the 'Guideline for perioperative management of hemophilia patients undergoing orthopaedic surgery in China ', in addition to members of the National Joint Surgery Group, and the Orthopedic Branch of the Chinese Medical Association for targeted investigation and analysis. Results A total of 17 domestic hospitals were included, all of which were general hospitals. Hospitals that started HO surgery treatment before 2000 accounted for 35.29%. A total of 3057 surgical cases of HO were reported by those hospitals. The most commonly performed surgical procedures were hip and knee joint replacement. The most commonly used coagulation factor replacement regimen was recombinant coagulation factor preparation. Ten hospitals reported finding patients with transfusion-related infectious diseases. Bleeding and hematoma formation were the most frequently reported surgical complications. Excessive length of hospital stay and high economic costs were the most frequently reported problems. Conclusions Surgical treatment for HO in 17 hospitals is mainly carried out in some large comprehensive medical centers in the eastern region. Compared with the patient base, the popularity and number of surgeries are still relatively insufficient. It is necessary to further standardize the treatment system by standardizing factor replacement and strengthening rehabilitation to improve surgical treatment outcomes.
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Due to its advantages of low wear,high stability and flexibility,the new generation metal-on-metal hip prosthesis is favored by many patients with hip diseases,especially young patients.However,in recent years,several studies have indicated that adverse reactions to metal debris (ARMD) caused the formation of inflammatory pseudotumor,which ultimately led to a higher revision rate after metal-on-metal hip arthroplasty.This aroused the widespread concern from doctors and patients.Moreover,revision surgery for metal-on-metal hip arthroplasty in the setting of inflammatory pseudotumor is faced with a great risk of failure because of the large defects of bone and surrounding soft tissue and difficulty in removing the original prosthesis and the fixing of the modified prosthesis.Therefore,the use of such products is restricted with caution in their choice.We summarized the recent developments in the research in the risk factors,diagnosis and treatment of inflammatory pseudotumor after metal-on-metal hip arthroplasty.The risk factors for the formation of inflammatory pseudotumor around the hip prosthesis mainly include the increase of metal ion concentration,the position of prosthesis implantation and the patient's own factors.The diagnosis mainly depends on physical examination,imaging examination,laboratory examination,arthroscopy and histological examination.The treatment strategies for clinical symptomatic and asymptomatic patients are also varies.Through the detailed analysis,evaluation and summary of the above contents,we may provide guidance for the selection of hip prosthesis,and lay the foundation for further exploration of the mechanism of inflammatory pseudotumor caused by ARMD.
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Due to its advantages of low wear, high stability and flexibility, the new generation metal-on-metal hip prosthesis is favored by many patients with hip diseases, especially young patients. However, in recent years, several studies have indicated that adverse reactions to metal debris (ARMD) caused the formation of inflammatory pseudotumor, which ultimately led to a higher revision rate after metal-on-metal hip arthroplasty. This aroused the widespread concern from doctors and patients. Moreover, revision surgery for metal-on-metal hip arthroplasty in the setting of inflammatory pseudotumor is faced with a great risk of failure because of the large defects of bone and surrounding soft tissue and difficulty in removing the original prosthesis and the fixing of the modified prosthesis. Therefore, the use of such products is restricted with caution in their choice. We summarized the recent developments in the research in the risk factors, diagnosis and treatment of inflammatory pseudotumor after metal-on-metal hip arthroplasty. The risk factors for the formation of inflammatory pseudotumor around the hip prosthesis mainly include the increase of metal ion concentration, the position of prosthesis implantation and the patient's own factors. The diagnosis mainly depends on physical examination, imaging examination, laboratory examination, arthroscopy and histological examination. The treatment strategies for clinical symptomatic and asymptomatic patients are also varies. Through the detailed analysis, evaluation and summary of the above contents, we may provide guidance for the selection of hip prosthesis, and lay the foundation for further exploration of the mechanism of inflammatory pseudotumor caused by ARMD.
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Objective To investigate the mid-and long-term effects of metal-on-metal hip resurfacing arthroplasty (HRA),and to analyze its related factors.Methods A total of 64 patients (81 hips) who underwent metal-on-metal HRA from June 2005 to January 2013 were recruited in the present study.There were 35 males (44 hips) and 29 females (37 hips) with the mean age of 48.26±10.45 years (20-65 years),including 47 unilateral and 17 bilateral HRAs.The cohort consisted of osteoarthritis secondary to the developmental dysplasia of the hip (23 cases,29 hips),necrosis of the femoral head (19 cases,22 hips),osteoarthritis (8 cases,10 hips),rheumatoid arthritis (5 cases,9 hips),ankylosing spondylitis (6 cases,8 hips),pigmented villonodular synovitis (2 cases,2 hips) and Otto's disease (1 case,1 hip).During the follow-up duration,radiographic features,including acetabular inclination angle,stem-femoral shaft angle,component loosening,osteolysis,femoral neck narrowing and heterotopic ossification,were evaluated by hip X-rays in straight and froglike position.The size and type of pseudotumor were assessed by MRI and ultrasonography.Clinical efficacy was evaluated by Harris hip score and the University of California at Los Angeles (UCLA) hip score.Considering revision surgery as the end point,the component survivorship was calculated.Results The mean follow-up was 7.98±2.21 years,ranging from 5.0 to 12.8 years.The mean postoperative Harris hip score (92.01 ±5.69) was higher than the preoperative score (41.93 ±9.09).The mean postoperative UCLA pain,walking,function,activity scores (9.37±0.86,9.14± 1.01,8.77± 1.09,6.47± 1.27,respectively) were improved when compared with the preoperative UCLA scores (3.57± 1.23,5.99± 1.30,5.00± 1.01,3.84± 1.41,respectively).The postoperative flexion,abduction and adduction,medial and lateral rotation of the hip was larger than the preoperative ones.Complications occurred in 10 hips (12.3％,10/81).Seven patients (8 hips) experienced early and intermediate complications,including one intraoperative femoral nerve injury,one deep femoral artery and saphenous nerve injuries during the same surgery,one unexplained pain of hip,one femoral neck fracture,three hips of heterotopic ossification,and one pseudotumour.There were mid-and long-term complications in two hips,including one narrowing of the neck and one pseudotumour which was occurred at 9 years.There was one patient (2 hips) underwent revision surgery twice at 5 months and 9 years.The former cause of revision was femoral neck fracture and the latter one was pseudotumour.The Kaplan-Meier survivorship was 98.8％ at five years,and 95.0％ at ten years.Conclusion Patients who underwent metal-on-metal HRA could obtain good mid and long-term results.Pseudotumour and unexplained pain of the hip are critical factors which can affect the mid-and long-term results and survivorship of metal-on-metal HRA.
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Objective To determine the effect of NEL-like type 1 gene (NELL-1) transfection in vivo in the repair of traumatic femoral head necrosis.Methods Twenty-four SD rats were randomly divided into three groups (8 rats per group) according to the lottery method,ie,sham group (served as normal control),NELL-1 treatment group (injected NELL-1 gene by recombinant adenovirus vectors around the hip one week after osteonecrosis model induced surgically) and placebo group (given an equal volume of saline solution at the same time after the induction of osteonecrosis).Femurs were taken from the animals 5 weeks after surgery.Gross observation was performed for morphology changes,X-ray assessment for femoral head height and length ratio (H/L),Micro-CT measure for bone parameters of femoral head including total volume (TV),bone volume (BV),total mineralized content (TMC),trabecular thickness (Tb.Th) and trabecular space (Tb.SP),and histological study for osteocytes,osteoblasts and osteoclasts.Results Preserved femoral head shape was noted in NELL-1 treatment group compared to the obvious flattening of the femoral head in placebo group.No heterotopic osteogenesis was observed in any group.Femoral head H/L ratio for 0.753 2 ± 0.040 2 in NELL-1 treatment group was higher than 0.598 4 ± 0.037 0 in placebo group (P ＜ 0.05),but lower than 0.920 2 ± 0.037 0 in sham group (P＜0.05).TV,BV,TMC and BMD between NELL-1 treatment and sham groups did not differ significantly (P ＞ 0.05),but all were increased compared to placebo group (P ＜ 0.05).There was no significant differences in Tb.Th and Tb.SP among three groups (P ＞ 0.05).Most osteocytes were alive in NELL-1 treatment group.More active osteoblasts and osteoclasts were noted in NELL-1 treatment group than those in placebo group.Conclusion NELL-1 gene transfection can preserve femoral head shape and bone content,promote osteoblast activity and neovascularization and hence is an effective treatment for rat traumatic osteonecrosis.However,the activity of osteoclasts is stimulated simultaneously.
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Objective To evaluate the method and clinical effect of subtalar joint distractor assisted open reduction and internal fixation of comminuted intra-articular calcaneal fracture.Methods Twenty-two patients with fresh closed calcaneal fracture treated with open reduction and internal fixation from May 2011 to July 2013 were included in the study.According to the modes of operation,the patients were randomly divided into two groups (n =11 in each):in group A patients underwent fracture reduction assisted by subtalar joint distractor and in group B patients underwent Steinmann pin traction and poking reduction.All were fixed using the lateral calcaneal plate.Operation time,B(o)hler angle,Gissanes angle,calcaneus height,incision healing time and complications of the two groups were investigated for evaluating the effect of operation.Clinical effect was evaluated using the American Orthopedic Foot & Ankle Society (AOFAS) score before the removal of internal fixation.Results Period of follow-up was (14.3±0.8)months (range,12 to 18 months).Two patients in group B had delayed wound healing,and were treated with regular wound care.At the final follow-up,no infection,nonunion,malunion and internal fixation failure were observed.B(o)hler angle,operation time and calcaneus height observed in group A were superior to those in group B (P ＜0.01).There was no significant difference in Gissanes angle between the two groups (P ＞ 0.05).Compared to the preoperative data,B(o)hler angle,Gissanes angle and calcaneus height were significantly improved in both groups (P ＜0.01).AOFAS score was (83.6 ± 1.4) points in group A and (81.7 ± 1.5) points in group B.Conclusion Subtalar joint distractor assisted open reduction and internal fixation is effective to shorten operation time,improve fracture reduction,reduce wound complications and increase the operative effect for comminuted intraarticular calcaneal fracture.
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Objective To investigate the clinical efficacy of fixation of distal radius fracture with dorsal instability with locking compression plate (LCP) via radial approach.Methods From September 2009 to October 2012, 21 cases underwent LCP fixation of the distal radius fracture with dorsal instability via radial approach.The study included 14 males and 7 females (mean age, 54.5 years;range, 38-81 years).Twelve cases were injured in traffic accidents, 7 in falls and 2 in high falls.Fracture AO classification was type A3 in 10 cases, type C1 in 8 cases and type C2 in 3 cases.Two cases (one type A3 and one type C1) had malunion.When the lateral column, intermediate column, radial edge and dorsal plane were exposed by radial incision, LCP fixation with bone grafting was performed to restore the height of radial styloid process, ulnar deviation and palmar tilt.According to the GartlandWerley score, wrist joint function was evaluated.Results Mean duration of follow-up was 13.5 months (range, 12 to 24 months).Stage Ⅰ bone union was shown on X-rays, with the healing time of 7.5 weeks.Based on the X-rays at postoperative 6 months, 1 year and 2 years, the shortening of radial styloid process was ≤ 2 mm, mean volar tilt was 12.5°(range, 8°-17°) , mean ulnar tilt was 20.5° (range, 15°-26°), and step-off or gap of the articular surface was ≤ 2 mm.In postoperative wrist motion assay, mean volar flexion was 60°(range, 30°-70°), mean dorsal flexion was 55° (range, 30°-65°), mean radial deviation was 17°(range, 10°-20°), mean ulnar deviation was 25.5° (range, 20°-30°),pronation was 65.5° (range, 60°-70°) , and mean supination was 75.5° (range, 60°-80°).Mean grip strength was 75％ (60％-95％)of the contralateral side.Two cases suffered from pain (one complained of moderate pain and one minor pain occasionally).According to the Gartland-Werley score, 16 cases were rated excellent, 2 good, 2 fair and 1 poor, with the excellent rate of 86％.No complication was found as injury of the superficial branch of radial nerve, infection, nonunion, nail loosening, medium neuritis and tendon injury.Conclusions Lateral column, intermediate column, radial edge and dorsal plane can be shown via the radial approach.LCP fixation combined with bone grafting contributes to fracture anatomical reduction.
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One option with minimally invasive surgery for treatment of painful osteoporotic vertebral compression fracture is percutaneous vertebroplasty or percutaneous kyphoplasty via an inflatable balloon tamp followed by stabilization with polymethylmethacrylate cement.The vertebral height is restored and the decreased loading ability of the fractured vertebral body is re-strengthened with pain relief.The effect of the method is widely demonstrated in those conditions.At the same time, the relative problems, such as the complications are being lucubrated and discussed.The reports on the re-fracture or height loss of the operated vertebrae with cemented augmentation are becoming more.By now, there are some unclear aspects on the problem: the definition of the re-fracture of the augmented vertebra is still unclear and not ascertained and the clinical manifestations are various.The mechanisms and correlative factors are still not clear-cut either.The rate of subsequent re-fractures after cemented augmentation from literature is fargoing, with a rate of 0％ to 63％.The correlative factors on the re-fracture of the operated vertebrae chiefly include: osteoporosis, bone necrosis caused by the heat injury from cement solidification,failure to achieve endplate-to-endplate cement augmentation, intravertebral cleft or avascular bone necrosis, premature mobilization or excessive movement, overfull reduction of the vertebral height, the biological character of the spine column, and so on.Great controversy still exists on the correlation between those possible factors and the re-fractures.More attention should be paid to this problem to explore the true risk factors and mechanism, decrease the re-fracutre rate, and elevate the clinical outcome in osteoporotic compression fractures.
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BACKGROUND:Many patients underwent aspirin anticoagulation in preventing cardiovascular disease before hip and knee replacement. No report addressed the effect of aspirin on blood loss during perioperative stage in patients receiving hip and knee replacement. OBJECTIVE:To observe the effect of perioperative continuous low-dose aspirin anticoagulation application on total hip arthroplasty or total knee arthroplasty. METHODS: A total of 40 patients with primary total hip arthroplasty or total knee arthroplasty were enroled in the Department of Orthopedics, Tianjin First Center Hospital from December 2012 to August 2013. According to anticoagulation scheme, they were divided into two groups (n=20). In the observation group, 100 mg/d aspirin anticoagulation was continuously used before replacement for a long period, and the medicine was not withdrawn except the day of replacement. In the control group, aspirin anticoagulation was not used, and their ages were similar to the observation group. The operation was conducted by the same physician in the observation and control groups. 10 patients received total hip arthroplasty and 10 patients received total knee arthroplasty in both groups. Bleeding was stopped actively during replacement. After replacement, pressurized ice compress was used to reduce bleeding. At 48 hours after replacement, wound drainage, perioperative hemoglobin and the incidence of complications were recorded. Joint function recovery was observed at 3 months of folow-up. RESULTS AND CONCLUSION:Hemoglobin levels before and after operation, postoperative blood drainage at 48 hours, perioperative hemoglobin changes, the incidence of complication, and joint function score at 3-month folow-up did not show significant difference between both groups. These findings indicate that it is safe to use some measures for reducing blood loss and continue low-dose aspirin in the perioperative period. The use of aspirin did not impact blood loss.
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BACKGROUND:Clinical fol ow-up studies have shown that alendronate is effective to prevent femoral head col apse fol owing traumatic osteonecrosis of the femoral head, but its mechanism remains poorly understood. OBJECTIVE:To analyze the effects and mechanisms of alendronate on prevention of col apse in traumatic osteonecrosis of the femoral head. METHODS:Total y 45 Sprague-Dawley rats were randomly divided into three groups, with 15 rats in each group. Placebo group received physiological saline after establishing models of avascular necrosis of the femoral head. Alendronate group received treatment of alendronate after model induction. Sham surgery group received an equal volume of physiological saline. At 5 weeks after model establishment, the rats were sacrificed. Femoral samples at the modeling side were col ected for general observation, X-ray irradiation, Micro-CT and histological detection. RESULTS AND CONCLUSION:General observation revealed that the femoral head was obviously deformed in the placebo group, but mild deformity was visible in the alendronate group. The ratio of height to width of the femoral head ranked as fol ows:sham surgery group>alendronate group>placebo group, showing significant differences. Micro-CT scanning results demonstrated that the mean number of bone trabecula was more in the alendronate group than in the placebo group, but less than sham surgery group, showing significant differences. The mean thickness of bone trabecula was less in the alendronate group than in the placebo group, but no significant difference was detectable as compared with the sham surgery group. The mean spacing of bone trabecula was less in the alendronate group than in the placebo group, but larger than in the sham surgery group, showing significant differences. Bone volume, bone surface area and bone mineral density were larger in the alendronate group than in the placebo group, but less than sham surgery group, showing significant differences. Histological detection results demonstrated that apparent sequestrum existed and osteoclasts were obviously inhibited in the alendronate group. The number of osteoclasts was noticeably less in the alendronate group than in the placebo group. Osteoblasts and new vessels were suppressed to some degrees. Results suggested that alendronate can inhibit curing reaction through inhibiting osteoclast and osteoblast activity and vessel formation, which can final y slow down the absorption of necrotic bone and preserve femoral head mass and shape. Thus, alendronate can be used as a preventive against femoral head col apse in rats with traumatic osteonecrosis of the femoral head.
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Objective To compare the discrepancy and consistency in mechanical axis and component position measured by electromagnetic navigation and radiograph in total knee arthroplasty (TKA)to assess whether the navigation system can be used as a substitute for radiograph.Methods A perspective study was performed on 40 cases (61 knees) undergone primary TKA under electromagnetic navigation from July 2006 to December 2006.There were 4 males and 36 females,at a mean age of (66.9 ±8.1) years (range,58-79 years).Mechanical axis angle,distal femoral and proximal tibial cut slope in coronal view (angles cα,β) were recorded both pre-and post-operatively with an intraoperative navigation system and compared against the mechanical axis angle,coronal femoral and tibial slope (angles α,β)measured via full-length radiograph of the lower limb preoperatively and at postoperative 3 months.Consistency in measurement of the same parameters with the two methods was assessed using intraclass coefficiency correlation (ICC).Results Mechanical axis determined by navigation and radiograph showed a mean valgus angle of 9.60° and 9.99° preoperatively and of 1.23° and 1.64° postoperatively,but the two pair parameters revealed no significant differences in the non-parametric test.Mean angle α determined by navigation and radiograph was 89.98° and 88.96° respectively (P ＜ 0.05),and mean angleβ was 90.21 ° and 89.59°respectively (P ＜ 0.05).With deviation value ≤3°,ICC for pre-and post-operative mechanical axis angles,angle α and angleβ was 0.887,0.754,0.632,0.640 respectively.Conclusions Within the acceptable range of deviation,intraoperative navigation data can reflect the pre-and post-operative mechanical axis and prosthesis position evaluated by radiograph.However,the advantages over the consistency of the two measurement methods rest with the evaluation of pre-and post-operative mechanical
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Objective To compare the lower limb alignment and prosthesis position after total knee arthroplasty (TKA) with or without using electromagnetic navigation.Methods Sixty-four patients (100 knees) underwent TKA under electromagnetic navigation,while 62 patients (100 knees) underwent conventional TKA.Three months after operation,the mechanical axial line angle and prosthesis position (angels α,β,γ) were measured via the full-length radiograph of both lower limbs and anteriorposterior and lateral Xrays of the knee.Results The average mechanical axial line angle and angle α were 1.20°±1.92°and 89.33°±1.64° in navigation group,respectively,and 2.31°±2.25° and 88.68°±2.57° in conventional group.And the differences were significant with regard to the above two indexes between two groups.The average angle β and angle γ were 89.64°±1.47° and 90.86°±2.37° in navigation group,respectively,and 89.26°±2.05° and 90.59°±3.44° in conventional group.However,the differences were not significant with regard to the above two indexes between two groups.After operation,mechanical axial line angle error was within ±3°in 86％ of patients in navigation group,while in 79％ of patients in conventional group; there was no significant difference between them.The angle α error was within 90°±3° in 92％ of patients in navigation group,while in 77％ of patients in conventional group; there was significant difference between them.However,there were no significant differences in percentage of patients whose errors of angle β and angle γ were within 90°±3° between two groups.Conclusion With using electromagnetic navigation in TKA,more precise prosthesis position and the mechanical axis can be achieved compared with the conventional technique.And its advantages mainly contribute to the coronal plane of the femoral side rather than the tibial side.
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Objective To evaluate the efficacy of plasma radiofrequency ablation at low temperature in disc combined with collagenase injection out of disc in patients with cervical intervertebral disc herniation.Methods Fifty-six patients suffering from cervical intervertebral disc herniation with headache,dizziness,and pain in the neck and in the shoulder were randomly divided into 2 groups ( n =28 each):collagenase injection out of disc group (group C) and plasma radiofrequency ablation at low temperature in disc combined with collagenase injection out of disc group (group R).All operations were carried out under CT guidance.Results At the sixth month of follow up after treatment,the remission rates of headache,dizziness and pain in the neck and in the shoulder were 86％,79％,and 93％ in group C and 96％,93％,and 100％ in group R,.respectively,with significant difference between the two groups ( P ＜ 0.05 ) Conclusion The efficacy of plasma radiofrequency ablation at low temperature in disc combined with collagenase injection out of disc is much better than collagenase single in patients with cervical intervertebral disc herniation.
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Objective To explore the causes and risk factors affecting early death in patients with traumatic cervical spinal cord injury (SCI). Methods Clinical data of 553 patients with traumatic cervical SCI were analyzed retrospectively to discuss the related factors affecting early death of patients with traumatic cervical SCI by using univariate analysis and multivariate logistic regression analysis. Results The early mortality of the patients with traumatic cervical SCI was 4.0% ( 22/553 ). The main causes of the early death were respiratory failure in nine patients (40.9%) and electrolyte disorders in five (22.7%). Univariate analysis showed that age, cervical spinal cord injury severity, complications in respiratory, cardiovascular, digestive systems and electrolyte disturbance as well as tracheotomy were considered statistically significant for early death in patients with traumatic cervical SCI ( P < 0, 05 ). Multivariate logistic regression analysis showed that age, cervical SCI severity, complications in respiratory,cardiovascular system and electrolyte disturbance as well as tracheotomy. Conclusion Severe cervical SCI, combined respiratory, cardiovascular system and electrolyte disorder complications as well as tracheotomy are high risk factors for the early death in patients with traumatic cervical SCI.
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@#ObjectiveTo investigate the characteristics of traumatic spinal cord injury (TSCI) urban inpatients of Tianjin in 2007. MethodsInpatients with TSCI of 8 hospitals in Tianjin in 2007 were reviewed. ResultsThere were 73 patients in total. Mean age was (51.34±14.597) years. Male∶Female was 3.56∶1. Falling, motor vehicle accidents （MVC） were the main causes of TSCI. The cervical spinal cord injuries were predominant. 26% were complete injury and 74% were incomplete. 6 cases were dead. Patients with ASIA grade D recover well. ConclusionFor the TSCI, the ages of patients increases and falling is the main cause.
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[Objective]To oberserve the method and efficacy of anterior microsurgical decompression and fusion via cervical disc space in the treatment of cervical spondylotic myelopathy.[Method]Forty-three patients were treated with microsurgical decompression via cervical disc space and fusion with PEEK(Polyetheretherketone)cages.Preoperative,immediate postoperative and follow-up X-ray films were utilized to oberserve the fusion rate of the segments,and to evaluate the restoration of lordosis(Cobb's angle)and intervertebral height.[Result]All patients were followed up with an average of 15.4 months.The fusion rate was 100% and the satisfactory rate was 88.4% according to the 40 score method.Immediate postoperative X-ray films showed 6.0?improvement in lordosis(P
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[Objective]To study the efficacy and related problems of lumbar microdiscectomy and small-incision discectomy in the treatment of lumbar disc herniation.[Method]A total of 82 cases were treated with lumbar microdiscectomy,70 cases were treated with small-incision discectomy.The results of two groups were compared.[Result]Compared with the small incision group,the operative time and the complication rates were significently reduced.The effective rate between the two groups had no significent difference.[Conclusion]Small-insion discectomy is as an effective operation as microdiscectomy,while lumbar microdiscectomy had the advantages of minimal invasive,more indications,less bleeding.Strict selection of indications,sufficient preoperative preparations and practiced surgical techniques are the key points of the two minimally invasive techniques to award good outcomes.
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Objective To investigate the feasibility of repairing the radius defect with inductive bone regeneration membrane combined with freezed allogenic bone. Methods Preparation PLGA/bBMP+IGF-Ⅱ+ bFGF complosite was prepared as artificial periosteum. Twenty seven rabbits with 1.0 cm long right radius segmental osteoperiosteum defect were werved as the animal model, and randomly assigned to 3 groups with 9 in eath group; Group A: the defects were connected with the PLGA/bBMP+IGF-Ⅱ+bFGF membrane and allogenic bone; Group B: the defects were treated with the PLGA/bBMP+IGF-Ⅱ+bFGF membrane; Group C: the defects were implanted only woth allogenic bone grafts. Animals were killed at 2, 4, 8 weeks postoperation respectively. The healing was study with radiological, histological and immunological methods. Results The osteogenic ability in PLGA/bBMP+IGF-Ⅱ+bFGF group was superior to that in the other groups. The defects of group A ware fully repaired at week 8; bony bridging under remodeling was observed in group B; and the putrescence of allogenic bone which was packaged by mass of connective tissue was observed with group C; Group A caused lower titer of antibody than group C and inhibited lymphocytes reproduction in vitro; There was significant difference between group A and group C. Conclusion PLGA/bBMP+IGF-Ⅱ+bFGF artificial periosteum had provided a excellent osteoinduction condition. Artificial periosteum combined with freezed allogenic bone can effectively promote the rapair of radius defects of rabbit.