摘要
目的:通过压配技术进行移植修复,并评价新鲜异体和自体骨软骨移植修复软骨缺损的差别。方法:实验于2004-01/05在解放军总医院骨科研究所完成。采用20只成年健康新西兰兔,随机分成2组,自体移植组和异体移植组,每组10只。制备髌股关节面的股骨槽沟内直径4mm的软骨缺损的动物模型,①自体移植组在手术过程中取兔右侧关节的骨软骨块植入左侧的股骨槽沟缺损骨洞内,并与股骨槽沟软骨面平齐,闭合切口。②异体移植组在手术过程中采用组内配对将配对兔右侧膝关节取出的骨软骨块经乳酸林格氏液冲洗后,植入同组配对兔左膝的缺损内,同样将同组配对兔右膝取出的备用软骨植入配对兔左膝的缺损内。③于手术后12周观察移植后兔的关节活动度、关节腔积液情况,关节挛缩、粘连及血管翳形成情况。修复组织的质地以及周围组织和基底部的结合程度。髌骨面的退变情况。观察软骨基质分泌情况应用苏木精-伊红染色和番红O染色。缺损处修复组织的超微结构行透射电镜观察。软骨缺损的组织学评分以半定量的改良Wakitaniscore法评估,内容包括:细胞种类,髓质染色(易染性),表面完整性,软骨的厚度,移植软骨在受体周围组织的完整性6个方面19项内容,采用0,1,2,3,4评分,最大总分14分。结果:所有动物在实验过程中全部成活,均进入结果分析。①移植软骨情况的大体观察:异体移植组移植后局部高度及颜色已与正常软骨一致,平滑且结合紧密,与周围及基底部界限模糊且质地坚硬。关节囊正常。自体移植组移植块无陷落,无倾斜,仍然完整,厚度不变。②移植后软骨的微观结构:光镜观察可见两组移植软骨均已覆盖缺损,与正常软骨高度相当,缝隙已接近连接,细胞成熟,有大量软骨基质分泌,细胞排列规则,番红O着色深。周围无淋巴细胞和浆细胞浸润。自体移植组移植软�
AIM： To evaluate the difference between fresh osteochondral allografts and autografts for articular cartilage defects by the press-fit technique. METHODS： The experiment was conducted in the research institute of Orthopaedics, General Hospital of Chinese PLA from January to May 2004. Twenty healthy adult New Zealand white rabbits were randomly and equally divided into two groups： autograft and allograft. Cartilage defects 4.0 mm in diameter were experimentally prepared in the left weight-bearing regions of the femur. ①Autograft group： Osteochondral graft was harvested from the right medial femoral condyle, and then was implanted to the defect of left medial femoral condyle, which was made parallel to the host cartilage surfaces. The incision was sutured. ②Allograft group： Allografts were harvest from the right knee of the rabbit to implant to the left knee each other by intra-group pair. All grafts were irrigated by the lactated Ringer＇s solution. The allografts from the right knee of one rabbit were implanted to the right knee of the other rabbit（the paired one） each other. ③The motion of joint, intraarticular effusion, contracture and conglutination of joints and formation of pannus were observed at 12 postoperative weeks. The texture of restored tissue, the fusion of the graft with its host and cataplasia of the patellaer surface were also observed. Hematoxylin and eosin staining and safranin O staining were used to observe the secretion of cartilage matrix. Transmission electron microscope was used to observe the uhrastructure of repaired tissues in the defect. The histological score of cartilage defect was assessed by semi-quantitative method modified by Wakitani, including classification of cells, medullary stainability, superficial smoothness, thickness of cartilage and cartilage fusion with peripheral tissues for a total of 19 items. They were scored by 0, 1, 2, 3, 4 marks with the maximal damage of 14 marks. RESULTS： All the rabbits survived and involved the result analysis. ① G
出处
《中国临床康复》
CSCD
北大核心
2005年第26期131-133,共3页
Chinese Journal of Clinical Rehabilitation
