|关键词||半月板 脱矿皮质骨 骨膜 异种异体 同种异体 移植|
|其他题名||An experimental study of the meniscus repair in rabbit with xenogenic demineralized cortical bone with lapine autologous periosteum|
目的：探讨异种异体脱矿皮质骨(Demineralized Cortical Bone, DCB)结合兔自体骨膜修复半月板缺失的效果。
To investigate the result of meniscus repair in rabbit with xenogenic demineralized cortical bone (DCB) with lapine autologous periosteum.
36 adult New Zealand white rabbits that had undergone total medial meniscectomy were randomly divided into three groups: control group, allograft group and study group. We implanted three different types of grafts into their right knees: bovine DCB, fresh allograft meniscus and bovine DCB with lapine autologous periosteum, respectively. There were 12 rabbits in each group. After death, at 6 weeks, 12 weeks and 24 weeks, the grafts’ healing process were examined respectively with general observation and biomechanics and pathology examination. The cartilage of the medial compartment of each group was assessed by gross and semiquantitative histologic analysis as well.
General observation of the grafts: which in control group were completely ruptured at 6 weeks, or even fall off into the joint, and were absorbed completely in 12 weeks. Which in allograft group were complete at 6 weeks. At 12 and 24 weeks, each group had 2 cases (50%) of the grafts appear obvious shrinkage to the naked eye. 3 cases (75%) healed well of study group at 6 weeks and all healed well at 12 and 24 weeks. At 6, 12 and 24 weeks, gross score differences of the allograft group and study group were no statistical significance (P > 0.05).
HE dyeing histology observation of grafts: All in control group were bone matrix without living cells and with obvious inflammatory cell infiltration at 6 weeks, and which were absorbed completely in 12 weeks. The grafts were complete in allograft group at 6 weeks but free edge became obtuse; at 12 weeks similar fibroblast cells of meniscus obviously increase the number of cells and matrix appeared more obvious loosely; matrix loose even more obvious at 24 weeks, and expanded to the free edge. Only 1 in study group was completely ruptured at 6 weeks, others healed well. But there were clear boundaries between bovine DCB and autogenous periosteum at 6 weeks, then good fusions came between 6 and 12 weeks.
Sirius red staining histology observation of grafts: Type Ⅲ collagen appeared in allograft group at 6, 12 and 24 weeks, and the scope expanding gradually to the free edge and even appeared collagen fiber loose in central region.
Toluidine blue staining histology observation of grafts: Allograft group were acterized by obvious light dyeing at 12 and 24 weeks; study group at 12 and 24 weeks with central ossification, peripheral could see a lot of hypertrophic chondrocytes.
Biomechanical testing of grafts: Hardness and elastic modulus of the hydrated bovine DCB and the allograft were both consistent with that of normal lapine meniscus (p > 0.05). Which of study group at 12 and 24 weeks were significantly higher than that of the normal lapine meniscus, and over time, the differences were more and more obvious (P < 0.05).
Naked eye and histological grading of cartilage：At 6, 12 and 24 weeks, the gross scores of the allograft group and the study group were better than in the control group, but the difference had no statistical significance (p > 0.05).
Toluidine blue and typeⅠcollagen staining observation of cartilage: As the transplant time extended, all three groups showed the trend of increase of the toluidine blue staining became shallow gradually dyed, gradually, and with the control group was most remarkble, allograft group was the least significant, the study group was between the two.
1. Fresh lapine allograft meniscus transplantation, which may be due to immunological rejection, collagen type gradually reduce with time, matrix loose gradually, eventually lead to graft failure.
2. Between 6 and 12 weeks after transplantation, repairing a missing meniscus combined with lapine autologous periosteum, bovine DCB passed through matrix remodeling, cell ingrowth process, forming the meniscus-like tissue, finally had good histocompatibility with the host. And had certain protective effect for the articular cartilage.
3. Combined with lapine autologous periosteum, bovine DCB had similar effect for protection of articular cartilage with the fresh allograft meniscus transplantation to repair missing meniscus.
|杨渝平. 异种异体脱矿皮质骨结合兔自体骨膜修复半月板缺失的实验研究[D]. 北京大学第三临床医学院. 北京大学,2016.|