摘要
背景:同种异体骨软骨移植修复关节软骨损伤可以解决自体骨软骨来源有限的问题,但存在免疫排斥问题。目的:观察以深低温保护剂保护的同种异体骨软骨柱移植修复兔关节软骨缺损的效果,并与自体关节软骨移植作比较。设计、时间及地点:随机对照动物实验,于2008-05/10在武汉协和医院骨科实验室完成。材料:24只成年健康新西兰兔中8只用于异体骨软骨柱的制备,16只随机分成同种异体移植组和自体移植组,每组8只。方法:使用横穿钉套筒提取兔股骨内侧髁骨软骨柱,将骨软骨柱在4℃条件下放入盛有10%二甲基亚砜的冻存管中2h,将冻存管移入程序冷冻仪内以1℃/min速率降至-75℃,放入-196℃液氮罐底部保存3周备用。用横穿钉钻头在兔左膝关节股骨内侧髁垂直于软骨面制造缺损,缺损深4mm,直径4.45mm,自体移植组取右膝关节内侧髁骨软骨柱植入到左侧膝关节相应缺损处,异体移植组将经过程序性深低温冷冻保存的同种异体骨软骨柱移植到相应缺损处。主要观察指标:术后12周观察兔关节活动度、修复组织的质地等情况。以苏木精-伊红染色观察关节软骨组织的病理变化,以半定量改良Wakitaniscore法进行评估。以免疫组织化学染色观察Ⅱ型胶原分泌情况。结果:两组实验动物关节活动度正常。异体移植组移植处关节软骨面较光整,与周围正常关节软骨高度一致,结合紧密,颜色接近,与自体移植组相似。两组移植后,兔关节缺损处被透明软骨覆盖,潮线整齐,细胞排列有序,分泌大量基质,异体移植组移植处软骨深层及软骨下骨处可见微小裂隙,未见淋巴细胞和浆细胞浸润。同种自体与异体骨软骨移植组Wakitaniscore评分结果无统计学差异,总分接近,修复软骨Ⅱ型胶原免疫组织化学染色均强阳性。结论:冷冻同种异体骨软骨柱移植可修复全层小面积关节软骨缺损,术后近期软骨细
BACKGROUND： AIIogenic osteochondral transplantation for the repair of cartilage defects can solve the problem that the source of autologous cartilage is insufficient, but it has problem of rejection. OBJECTIVE： To observe the efficacy of cryopreserved osteochondral pillar transplantation on repair of articular cartilage defect in the knee joint of rabbit, in comparison with autologous cartilage transplantation. DESIGN,TIME AND SITE： This randomized controlled animal experiment was performed at Laboratory of Orthopedics, Wuhan Union Hospital from May to October in 2008. MATERIAL： Twenty-four healthy adult New Zealand white rabbits were used in this experiment. Eight of them were selected for preparation of allogenic osteochondral pillars. Others were randomly divided into two groups： allograft group and autograft group, with 8 rabbits in each group. METHODS： Osteochondral pillars of condylus medialis femoris were harvested from rabbits by using bush of cross pin system. The osteochondral pillars were put into cryogenic vials which filled with 10% DMSO for 2 hours at 4 ℃. They were shifted into refrigerator which refrigerate pillars at the rate of 1 ℃ per minute down to -75 ℃, and then shifted to the bottom of nitrogen canister for 3 weeks. Drill of cross pin system was used to make defects vertically to cartilage face at condylus medialis femoris of left knee joint in rabbits. The defects were 4.45 mm in diameter and 4 mm in deep. In the autograft group, the osteochondral pillars of condylus medialis femoris of the right knee joints were harvested, and then implanted into the corresponding defects in left knee joints. In the allograft group, the osteochondral pillars of condylus medialis femoris by cryopreservation were transplanted into corresponding defects. MAIN OUTCOME M EASURES： The motion of joints and the texture of repaired tissues were observed at 12 weeks after operation, Pathological changes of articular cartilages were observed by hematoxylin-eosin staining. Modified semi-quanti
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第31期6050-6054,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
