摘要
目的:观察在全层软骨缺损深部制造“微骨折”对兔软骨修复的影响。方法:实验于2003-04/10在同济医学院矫形外科实验室完成。实验用自制“微骨折”骨刀由管形不锈钢制作而成,分微骨刀内芯和外置套筒两部分。微骨刀近端配有可拆卸的螺帽,其远端为4枚锋利的钢钉,孔距为4mm,其连线呈正方形,孔隙深4mm,可深达松质骨内。取20只大白兔随机分2组,每组10只。用尖刀片在兔股骨内髁处切除6mm×6mm软骨组织造成全层关节软骨缺损,建立实验动物模型。实验组在缺损局部应用特制骨刀造成“微骨折”,对照组缺损局部不予特殊处理。分别在4周和8周每组各处死5只实验兔,作大体观察以及组织病理学检查。结果:①两组兔缺损修复处大体观察:在缺损处对照组只有肉芽组织和瘢痕组织生长,仅边缘有少量软骨组织生长,实验组在4周时大部分为软骨组织生长,而8周已全部被软骨组织修复。②组织病理学观察:实验组在4周时修复组织以纤维软骨为主,还有大量幼稚的透明软细胞,排列较紊乱,内混有一些纤维组织,与正常的关节软骨组织有一定的差异。而对照组修复组织均为红染的肉芽组织和纤维瘢痕组织,8周时,仅为瘢痕组织。③关节活动度的变化:术后各组动物关节活动度良好。结论:采用特制骨刀在全层软骨缺损的情况下合并“微骨折”,能使全层缺损的软骨组织得以修复。
AIM： To observe the influence of rabbits cartilage repair by full-thickness cartilage defect with deep microfracture.
METHODS： The experiment was conducted in the laboratory of Orthopedic Surgery, Tongji Medical College from April to October 2003. In the experiment, the bone knife was self-made of tube stainless steel and composed of inner core and out sleeve. There was a detachable nut at the proximate end of the knife and four sharp steel nails at the distal end with pore distance of 4 mm, and a square line; the pore was 4 mm in depth, which could reach cancellous bone. Twenty rabbits were randomly divided into two groups with 10 ones in each group. Full-thickness cartilage defects of 6 mm×6 mm were made over the articular surface of medial malleolus of femur to establish the models. The experimental group received microfracture made in the surface of defects by self-made bone knife, and the control group was not given any treatment. Five rabbits of each group were sacrificed postoperatively at the end of 4 and 8 weeks for gross observation and histopathological examination.
RESULTS： ①Gross observation of the defects： In the control group, granulation tissue and scar tissue were formed in the cartilage defects, and only little cartilage tissue was found at the border. Conversely, in the model group, the cartilage tissue were found in the cartilage defects at the forth week; moreover, all of the cartilage defects were replaced by cartilage-like tissue at the eighth week. ②Histopathological examination： Cartilago fibrosa was predominant in the experimental group at the forth week with plenty of immature hyalocytes, which arranged irregularly and mixed with some fibrous tissue, it was different from normal articular cartilage tissue. While in the control group, the repair tissue was red-stained granulation tissue and scar tissue; at the eighth week, only scar tissue left. ③Changes in motion degree of joint： The motion of joint of animals in each group was excellent after operation.
CONCLUSION： The full-thickness cartilage defect could be repaired well with deep microfracture by self-made bone knife.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第14期2688-2690,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
