摘要
目的：对于严重损伤的半月板全切除术后行自体游离骨膜重建半月板，以维持膝关节结构、生理及功能特性。方法：使用１７只成年犬，５只幼犬。外侧半月板全切除以后，胫骨内侧近端的骨膜游离并移植到外侧半月板部位。于２、４、８、１２、２４、４８周取下重建半月板及不同部位的关节面软骨进行大体、光镜及电镜观察。结果：术后２个月，重建半月板的大体形态、组织结构与正常半月板近似。外侧股骨软骨面及没有被覆盖的胫骨软骨面表现退行性改变，被移植物覆盖的软骨面退变较轻。幼犬的退变更早、更严重。结论：本研究说明了自体游离骨膜在滑液环境及受到合适的应力刺激会向纤维软骨演化，在半月板全切除后。
Objective:This is an experimental study on the meniscus reconstruction of the knee joint with free periosteal grafts as a potential method to replace a severely damaged meniscus and to maintain the structural, physiologic and functional characters of the knee joint. Methods:17 adult and 5 adolescent dogs were used for the experimental study .After total lateral meniscectomies, the periosteal autografts taken from the medial aspect of the proximal tibia were transplanted into the lateral meniscal cavity defects and sutured to the perimeniscal capsular and synovial tissues. The reconstructed meniscus and articular cartilage were observed by optical and electron microscopes at 2,4,8,12,24,48 weeks respectively. Results:The results showed that the grafts were similar to the normal meniscus in their gross and histological appearances by two months. The degenerative changes were noted in the lateral femoral and tibial articular cartilage which were not covered by the grafts , but the cartilage beneath the grafts presented slight degenerative changes . In theadolescent dogs, the degenerative changes were much worse and faster. Conclusion: This study demonstrated that the free periosteal grafts had a potential of fibrochondrogenic differentiation in the synovial fluid and under the effect of the stress stimulation, and was feasible for meniscal reconstruction after total meniscectomy.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1998年第9期547-550,I004,共5页
Chinese Journal of Orthopaedics
关键词
骨膜移植
半月板
膝关节
自体移植
Periosteum Transplantation,autologous Menisci,tibial,restorative
