CAJ | 학술논문

目的评价应用微骨折技术结合自体骨软骨碎屑样团块移植修复兔膝关节软骨缺损的效果. 方法取健康成年新西兰大白兔46只,随机分为3组:对照组10只,微骨折组18只,实验组18只.制作膝关节软骨缺损模型,对照组不做其他任何处理；微骨折组利用微骨折技术制作网格状微孔；实验组在制作网格状微孔后在缺损表面填盖上碎屑样软骨团块.术后4、8、12周行大体观察、组织学观察及Wakitani组织学评分、糖胺聚糖(GAG)含量测定结果术后12周实验组缺损由透明软骨样组织填充,软骨及软骨下骨组织基本恢复,修复的软骨组织在大体观察、组织形态学方面均优于微骨折组和对照组.术后4、8、12周实验组Wakitani组织学评分平均分别为(5.0±1.0)、(6.7±1.5)、(13.0±1.0)分,微骨折组平均分别为(2.3±0.6)、(5.0±1.0)、(7.7±1.2)分,对照组平均分别为(0.0±0.0)、(1.3±0.6)、(1 7±0.6)分,实验组不同时间点评分均高于微骨折组和对照组,差异有统计学意义(P＜0.05).术后4、8、12周实验组GAG含量平均分别为(6.25±0.31)、(13.11±0.21)、(16.23±0 66) μg/mg,微骨折组平均分别为(3.04±0.21)、(5.75±0.24) 、(7.03±0.21) μg/mg,两组比较差异均有统计学意义(P ＜0.05). 结论微骨折技术结合自体骨软骨碎屑样移植是一种治疗软骨缺损的新选择,其能够有效提高软骨修复的效果.
목적 평개응용미골절기술결합자체골연골쇄설양단괴이식수복토슬관절연골결손적효과. 방법 취건강성년신서란대백토46지,수궤분위3조:대조조10지,미골절조18지,실험조18지.제작슬관절연골결손모형,대조조불주기타임하처리；미골절조이용미골절기술제작망격상미공；실험조재제작망격상미공후재결손표면전개상쇄설양연골단괴.술후4、8、12주행대체관찰、조직학관찰급Wakitani조직학평분、당알취당(GAG)함량측정 결과 술후12주실험조결손유투명연골양조직전충,연골급연골하골조직기본회복,수복적연골조직재대체관찰、조직형태학방면균우우미골절조화대조조.술후4、8、12주실험조Wakitani조직학평분평균분별위(5.0±1.0)、(6.7±1.5)、(13.0±1.0)분,미골절조평균분별위(2.3±0.6)、(5.0±1.0)、(7.7±1.2)분,대조조평균분별위(0.0±0.0)、(1.3±0.6)、(1 7±0.6)분,실험조불동시간점평분균고우미골절조화대조조,차이유통계학의의(P＜0.05).술후4、8、12주실험조GAG함량평균분별위(6.25±0.31)、(13.11±0.21)、(16.23±0 66) μg/mg,미골절조평균분별위(3.04±0.21)、(5.75±0.24) 、(7.03±0.21) μg/mg,량조비교차이균유통계학의의(P ＜0.05). 결론 미골절기술결합자체골연골쇄설양이식시일충치료연골결손적신선택,기능구유효제고연골수복적효과.
Objective To evaluate the effectiveness of microfracture plus autologous osteochondral paste transplantation in treatment of knee cartilage defects in rabbits. Methods Models of articular cartilage defects were established in 46 healthy adult male New Zealand rabbits which were divided into 3 groups:control group ( n =10),microfracture group ( n =18) and experiment group ( n =18).In the control group,the cartilage defects were left untreated.In the microfracture group,multiple grid-like mini-holes were made using the microfracture technique.In the experiment group,the defects were covered with autologous osteochondral paste after the grid-like mini-holes were made.At 4,8 and 12 weeks post-treatment,the knees were assessed grossly,histologically,and by glycosaminoglycan (GAG) content measurement and Wakitani scoring. Results After 12 weeks,the defects in the experiment gronp were filled with hyaline-like cartilage tissue,and both the cartilage and the subchondral bone were basically repaired.The repaired cartilage was superior to those in the other groups in terms of gross appearance and histomorphology.The Wakitani histological scores at 4,8 and 12 weeks post-treatment were respectively 5.0 ± 1.0,6.7 ± 1.5 and 13.0 ± 1.0 in the experiment group,2.3 ±0.6,5.0 ± 1.0 and 7.7 ± 1.2 in the microfracture group,and 0.0 ± 0.0,1.3 ± 0.6 and 1.7 ± 0.6 in the control group.The experiment group was significantly better then the other 2 groups in all the above indexes ( P ＜ 0.05 ).The GAG contents at 4,8 and 12 weeks post-treatment were respectively 6.25 ±0.31 μg/mg,13.11 ±0.21 μg/mg and 16.23 ±0.66 μg/mg in the experiment group,and 3.04 ±0.21 ug/mg,5.75 ±0.24 μg/mg and 7.03 ±0.21 μg/mg in the microfracture group,with significant differences between the 2 groups ( P ＜ 0.05). Conclusion Microfracture plus autologous osteochondral paste transplantation may be a promising treatment option for cartilage defects because it is much more effective than microffacture alone.