摘要
目的观察带蒂骨膜-骨复合组织瓣局部转移修复全层骨软骨缺损的效果及再生软骨的特性。方法新西兰成体大白兔48只作为实验动物,建立兔单侧髌股关节股骨关节面直径6mm的圆柱状全层软骨缺损模型,设计带蒂骨膜-骨复合组织瓣局部转移为实验组、单纯骨膜游离移植为对照组、未作任何干预处理为空白组,每组16只。分别于术后2、4、8、12周进行大体观察、HE染色、甲苯胺蓝染色组织学观察、免疫组化观察、扫描电镜观测、修复组织(RT)的生物力学观察以及厚度测量。结果术后实验组修复组织为透明软骨,且与周围正常软骨融合良好,甲苯胺蓝染色深;细胞质和细胞外基质中Ⅱ型胶原的表达呈强阳性;电镜显示包埋在软骨细胞囊中的软骨细胞排列整齐,胶原纤维呈多孔结构,孔隙均匀;应力-应变曲线、时间-应力曲线、时间-应变曲线具有良好的黏弹性表现,其生物力学性能明显强于对照组和空白组(P<0.05);修复组织(RT)厚度测量结果表明实验组和对照组均稍高出毗邻软骨,但与毗邻软骨之间的厚度差异均无统计学意义(P>0.05)。结论带蒂骨膜-骨复合组织瓣局部转移修复骨软骨缺损比以往单纯游离骨膜移植优势明显,为修复全层软骨缺损提供了更为有效的方法 。
Objective To observe the effects of the pedicled periosteum-bone composite tissue flap transfer locally for the repair of full-thickness osteochondral defects and the characteristics of cartilage regeneration. Methods 48 New Zealand adult rabbits were chosen as experimental animals, and the rabbit unilateral patellofemoral joint femoral articular surface 6mm-diameter cylindrical full-thickness cartilage defect model was established. The experimental group was rabbits with pedicle periosteal-bone composite tissue flap transferred, the control group was rabbits with simple free periosteum transplantation, and the blank group was rabbits without any intervention treatment, with 16 ones in each group. Gross observation, HE staining, aniline blue staining histological observation, immunohistochemical observation, scanning electron microscope, biomechanical observation of repair tissue （RT） and thickness measurement were performed respectively 2, 4, 8, 12 weeks after surgery. Results The RT in the experimental group after surgery was hyaline cartilage, which was fused well with the surrounding normal cartilage, and toluidine blue staining was deep; The expression of collagen type II in the cytoplasm and the extracellular matrix was strong positive; Electron microscopy showed that cartilage cells entrapped within the cartilage capsule arranged neatly and the collagen fibers were in a porous structure with uniform pores; Stress-strain curve, time-stress curve and time-strain curve were with good viscoelastic performance, whose biomechanical properties were significantly stronger than that in the control group and blank group （P〈0.05）; RT thickness measurement showed that the results in the experimental group and the control group were slightly higher than that of the adjacent cartilage, but there was no significant differences in thickness between the adjacent cartilage （P〉0.05）. Conclusions The pedicled periosteum- bone composite tissue flap transfer locally for the repair of osteochondral defects has more obvious advantages than simple free periosteum transplantation, and provides a more effective method for repair of full-thickness cartilage defects.
出处
《中国骨与关节杂志》
CAS
2012年第6期631-638,共8页
Chinese Journal of Bone and Joint
关键词
关节
软骨
骨膜
移植
Joint
Cartilage
Periosteum
Transplantation
