摘要
目的:为了解决关节骨软骨急性损伤后的修复问题,通过观察研究组织工程联合自体骨软骨柱移植能否满意修复大面积骨软骨缺损并实现修复组织间的整合,以寻找一种适合临床应用的大面积骨软骨损伤修复方法。方法:2004-01/07于上海第二医科大学附属第九人民医院骨科实验室进行组织工程联合自体骨软骨柱移植修复大面积骨软骨缺损的研究。首先体外培养骨髓基质干细胞(BMSCs),胰岛素样生长因子-I(insulin-likegrowthfactor-I,IGF-I)及转化生长因子-β(transforminggrowthfactor-β,TGF-β)进行诱导,最后复合藻酸钙凝胶。在自体骨软骨柱移植修复山羊股骨内髁负重区骨软骨缺损的同时,将细胞/基质材料复合物填充于骨软骨柱间的空隙。以单纯自体骨软骨柱移植为对照,通过组织学及免疫组织化学等方法进行检测。结果:两组的自体骨软骨柱的移植软骨均存活,和周围的原始软骨之间没有差别,维持透明软骨的特性。实验组软骨间的空隙区有新生软骨修复,结构与周围正常软骨类似,软骨交界区整合良好;对照组各时间点见软骨间的空隙区为纤维组织或纤维软骨修复,交界区有裂隙。4,12,24周O'Driscoll,KeeleyandSalter组织形态学评分实验组分别为(15.00±0.63),(18.83±1.17)和(22.17±0.75)分,对照组分别为(7.50±1.38),(8.00±0.63)
AIM: In order to solve the repair of the osteochondral defects,to investigate whether tissue engineering combined with autologous osteochondral cylinder transplantation can repair osteochondral injury satisfactorily and get the integration of the tissue, so as to find out a repairing method suitable for the clinical application of large area osteochondral defects.METHODS: The experiment on the repair of large area osteochondral defects by using tissue engineering combined with autologous osteochondral cylinder transplantation was done in the orthopaedic laboratory of Ninth People's Hospital affiliated to the Shanghai Second Medical University from January to July 2004. Bone marrow stromal cells(BMSCs) were cultured in vitro firstly,then induced with insulin like growth factor I(IGF I) and transforming growth factor beta(TGF β ),and finally embedded into the alginate.Autologous osteochondral cylinder transplantation was used to repair the osteochondral defects in the mass loading area of the femoral medial condyle of the goats, meanwhile compound of the induced BMSCs and the alginate were filled in the interspace among the cartilage.The pure autologous osteochondral cylinder transplantation was taken as a control. Histological and immunohistological studies were performed.RESULTS: The transplanted cartilages of both groups were survived and had no difference from the regular surrounding cartilage,keeping the characteristic of hyaline cartilage.In the experimental group, the interspace among the cartilage was repaired with the regenerative cartilage.The structure was similar to the surrounding cartilage and the integration of the boundary was good.The interspace among the cartilage of the control group was repaired with the fibrous tissue or fibrous cartilage. The O'Driscoll, Keeley and Salter tectology grades showed that the scores were all significantly higher in the experimental group[(15.00± 0.63),(18.83± 1.17),(22.17± 0.75)points]than in the control group[(7.50± 1.38), (8.00± 0.63),(8.67± 0.
出处
《中国临床康复》
CSCD
北大核心
2005年第6期32-34,i001,共4页
Chinese Journal of Clinical Rehabilitation
基金
上海市领先学科基金资助(993022)~~
