CAJ | 학술논문

目的探讨微粒骨膜-三维支架修复大面积关节软骨缺损的有效性和可行性.方法于兔股骨滑车关节面制作直径4.5 mm深达软骨下骨板的全层软骨缺损模型,缺损处随机行自体微粒骨膜-纤维蛋白混凝物、单纯纤维蛋白"浇铸"移植.分别于术后3 h、4 d及1、2、4、8、12、24周取材,行大体观察、苏木素.伊红(HE)、Masson及藏红花(safranin-0)染色组织学检查,并进行组织学评分半定量分析.结果微粒骨膜.三维支架制备简便.微粒骨膜被均匀种植于纤维蛋白三维支架中,可随意"浇铸"充填骨软骨缺损,移植物不易脱落,手术1次完成.术后微粒骨膜在缺损空间内全方位迅速增殖、分化、分泌基质完成缺损骨软骨修复.新生软骨具有与周围正常软骨基本一致的厚度、细胞形态及排列、基质胶原及蛋白多糖染色,且与周边软骨及软骨下骨结合良好.术后4、8、12及24周,两组组织学评分差异有统计学意义(P<0.05).结论该方法能简单高效地构建工程化组织复合体,随意浇铸充填软骨缺损,完成较大面积关节软骨缺损的生物性修复.
목적 탐토미립골막-삼유지가수복대면적관절연골결손적유효성화가행성.방법 우토고골활차관절면제작직경4.5 mm심체연골하골판적전층연골결손모형,결손처수궤행자체미립골막-섬유단백혼응물、단순섬유단백"요주"이식.분별우술후3 h、4 d급1、2、4、8、12、24주취재,행대체관찰、소목소.이홍(HE)、Masson급장홍화(safranin-0)염색조직학검사,병진행조직학평분반정량분석.결과 미립골막.삼유지가제비간편.미립골막피균균충식우섬유단백삼유지가중,가수의"요주"충전골연골결손,이식물불역탈락,수술1차완성.술후미립골막재결손공간내전방위신속증식、분화、분비기질완성결손골연골수복.신생연골구유여주위정상연골기본일치적후도、세포형태급배렬、기질효원급단백다당염색,차여주변연골급연골하골결합량호.술후4、8、12급24주,량조조직학평분차이유통계학의의(P<0.05).결론 해방법능간단고효지구건공정화조직복합체,수의요주충전연골결손,완성교대면적관절연골결손적생물성수복.
Objective To explore the effectiveness and the feasibility of microperiosteum-scaffol-ded repair of larger defect of articular cartilage. Methods A larger (4.5 ram-in diameter) ,full-thlckness defect of articular cartilage were made in the femoral groove of New Zealand White rabbits. Microperioste-tun was prepared and dispersed in fibering glue, then transplanted into defects by means of tapecasting. The contralateral knee served as a control : only fibering glue was transplanted into defects in the same way. The distal parts of the femur were harvested at the end of 3 h,4 days and 1,2,4,8,12,24 weeks postoperative-ly ,and were examined grossly and histologically. The tissues were stained with HE, Masson (for collagen of articurlar cartilage) and safranin-O (for GAG). Results The microperiosteum- fibering glue could be prepared simply,and could be transplanted freely into defects by the means of tapecasting. This approach could be accomplished easily by no more than one operation. Throughout the defects were repaired as MSCs of the microperiosteum proliferated tremendously and secreted special cartilage matrix; The new cartilage was the same as the surrounding normal cartilage in its thickness, cellular histology, special staining for collage and GAG, and was excellently integrated with surrounding cartilage and subcartilage bone as well.There were significant differences (P <0.01) in histologic scores between control group and microperios-team-scaffolded graft group at the end of 4,8,12,24 weeks postoperatively. Conclusion The approach can construct tissue complex, and microperinsteum- fibering glue can transplanted freely by the means of tapecasting and repair the defects of articurlar cartilage; It may be a useful alternative in the repair of large,full-thickness defect of joint surfaces.