胶原复合梯度磷酸三钙修复髁突软骨缺损

目的 研究胶原复合梯度磷酸三钙(Col/TCP)修复髁突软骨损伤的效果.方法 选用成年雄性新西兰大白兔30只,在实验动物的右侧髁突前斜面形成3 mm × 4 mm的全层缺损后,植入复合材料;左侧仅造成同样的缺损.分别于术后4、6、8、12和24周各处死6只实验动物,对缺损区的新生软骨进行大体标本、组织学、免疫组织化学及透射电镜观察.结果 实验组4周后复合材料即可诱导关节软骨的修复;12周时缺损区与周围正常软骨基本一致,且与关节下骨结合紧密;24周后再生软骨未见明显褪变;对照组缺损区由纤维组织充填,未见软骨形成.实验组Ⅱ型胶原免疫组织化学染色呈阳性,对照组为阴性;透射电镜观察实验组见典型软骨细胞出现,对照组为纤维组织.结论 Col/TCP可以修复髁突软骨缺损,形成类似正常的关节软骨.     

经内镜移植软骨块修复颞下颌关节面缺损的实验研究

目的 探讨经关节镜移植自体耳廓软骨块修复颞下颌关节骨软骨缺损的可行性与修复机制。方法 于12只猕猴获取一定量的自体耳廓软骨块,经关节镜植入关节骨软骨缺损区;4周、12周和24周后经组织学观察、免疫组织化学染色评价修复情况。结果 术后8周,关节面缺损区基本与正常组织平齐。随着时间的推动,修复区软骨细胞数量逐渐减少,代之以成纤维细胞构成的胶原纤维;免疫组织化学染色II型胶原呈现弱阳性。结论 软骨块移植可修复颞下颌关节软骨损,但修复组织为纤维软骨样组织,随时间推移,逐渐成为纤维组织。     

内镜下软骨细胞移植修复颞下颌关节软骨缺的实验研究

探讨经关节镜植入软骨细胞修复颞下颌关节软骨缺损的可行性和修复组织的质量。方法 经关节镜对12只猕猴的髁突和（或）关节结节进行钻孔,造成骨软骨缺损模型;将软骨细胞悬液与人工基质材料PluronicF127混合形成复合物,经关节镜注入颞下颌关节面缺损区;4周、8周、12周和24周后经大体形态观察、组织学观察、免疫组织学染色评价修复情况。结果 软骨细胞移植术后,关节面缺损均得到了修复,修复组织内为分化良好的软骨细胞,并随时间推移排列逐渐有序;免疫组化染色发现修复组织Ⅱ型胶原染色明显。结论 关节镜导向下的细胞移植术是切实可行的。软骨细胞移植能修复关节面骨软骨缺损,修复组织接近正常的关节软骨组织。     

髁突软骨急性损伤自然修复的实验研究

目的观察兔髁突软骨不同程度急性损伤后的修复能力、修复组织的性质及其细胞来源。方法选用成年雄性大白兔４４只，随机分成４组。第一组：单纯髁突软骨全层损伤组，将实验动物的髁突前斜面去除直径２ｍｍ的全层关节软骨；第二组：伴有软骨下骨皮质穿通的髁突软骨全层损伤组，在实验动物的髁突前斜面形成一直径２ｍｍ同时穿透关节软骨全层和软骨下骨皮质的缺损；第三组：空白手术对照组；第四组：正常对照组。结果单纯髁突软骨损伤组损伤区形成纤维组织性部分修复；伴有软骨下骨皮质穿透的髁突软骨全层损伤后，４～８周时损伤区有软骨组织形成，此后，逐渐变成致密骨组织。结论髁突软骨急性损伤后最终不能形成软骨组织修复。修复细胞来源于骨髓的未分化间充质细胞。     

醋酸泼尼松龙对髁突软骨急性损伤后修复的影响

目的　研究局部应用糖皮质激素类药物对髁突软骨损伤后修复再生的影响。　方法选用成年雄性大白兔 37只 ,分成 4组。第 1组 :髁突软骨全层损伤后局部应用醋酸泼尼松龙组 ;在兔髁突的前斜面形成直径 2mm的软骨全层缺损 ,局部应用醋酸泼尼松龙 2 5mg。第 2组 :单纯髁突软骨全层损伤组。第 3组 :空白手术对照组。第 4组 :正常对照组。结果　第 1组动物的髁突软骨损伤区骨皮质断端进行性增生 ,术后 12周时 ,原损伤区几乎充满致密骨质 ,表面有纤维组织覆盖。结论　醋酸泼尼松龙可促进髁突软骨损伤后的组织修复     

软骨细胞移植修复髁突软骨损伤的实验研究

目的 研究软骨细胞移植修复髁突软骨损伤后的效果及修复组织的性质。方法 选用成年雄性白免５３只,分成５组。第１组：细胞移植组;第２组：单纯胶原膜植入组;第３组：在实验动物有髁突前斜面形成直径２ｍｍ的全层损伤后,未植入任何物品;第４组：空白手术对照组;第５组：正常对照组。结果 细胞移植组动物的髁突软骨损伤区形成软骨组织修复。结论 异体兔髁突软骨细胞移植能够形成类似正常的关节软骨修复髁突软骨缺损。     

髁状突软骨缺损自身修复能力的实验研究

本实验研究以家兔作为实验对象，在家兔的左侧颞颌关节髁状突造成４×５ｍｍ２大小的全层软骨缺损，分别于术后２，４，８，１２和１６周处死动物，对缺损区的修复组织进行组织学和组织化学观察。结果表明：造成髁状突软骨缺损术后４至８周修复组织一度趋向透明软骨形成，但在术后８周以后开始退变，１６周时修复组织为纤维组织，纤维软骨组织或薄层无增殖能力的软骨，而不是透明软骨。由此说明：单纯髁状突软骨层切除术后其组织结构不能恢复正常。     

羧甲基壳聚糖对兔颞下颌关节软骨修复的作用

目的：比较羧甲基壳聚糖与透明质酸钠对兔颞下颌关节软骨损伤后修复的作用。方法：27只新西兰白兔，随机分成4组：A组10只、B组10只、C组5只、D组2只。A、B、C组于下颌髁突功能面制造直径2mm、深2．0-2．5mm的骨、软骨缺损，局部分别应用羧甲基壳聚糖、透明质酸钠、生理盐水2．0ml处理，D组为健康对照组。术后1、2、4、8、12周处死实验动物，D组动物和手术组于术后1周和12周同时处死。取髁突标本进行大体形态和组织学观察。结果：B、C组软骨损伤区形成骨纤维组织修复，术后12周，C组出现明显的软骨退行性变，B组无明显退变：A组软骨缺损区形成软骨样组织修复，且与邻近正常软骨层相连续，未见明显的软骨退变。结论：羧甲基壳聚糖有明显促进关节软骨再生修复和减轻关节软骨退变的作用；透明质酸钠无明显促进关节软骨再生修复的作用，但具有减轻关节软骨退变的作用。     

醋酸泼尼松龙对髁突软骨争性损伤后修复的影响

目的 研究局部应用糖皮质激素类药物对突软骨损伤后修复再生的影响。方法 选用成年雄性大白兔３７只，分成４组。第１组：髁突软骨全层损伤后局部应用醋酸泼尼松龙组；在兔髁突的前斜面形成直径２ｍｍ的软骨全层缺损，局部应用醋酸泼尼松龙２５ｍｇ。第２组：单纯突软骨全层损伤组。第３组：空白手术对照组。第４组：正常对照组。结果 第１组动物的髁突软骨损伤区骨皮质断端进行性增生，术后１２周时，原损伤区几乎充满致密骨质，     

透明质酸钠和泼尼松龙对兔颞下颌关节软骨损伤治疗效果的研究

目的 比较局部应用透明质酸钠和泼尼松龙对兔颞下颌关节软骨损伤的治疗效果。方法 选用成年健康新西兰大白兔27只,随机分成4组。第1组:兔颞下颌关节髁突软骨全层损伤后局部应用泼尼松龙(12.5 mg),10只;第2组:兔颞下颌关节髁突软骨全层损伤后局部应用透明质酸钠(5 mg),10只;第3组:兔颞下颌关节髁突软骨全层损伤手术对照组,5只;第4组:正常对照组,2只。分别于术后1、2、4、8、12周处死,对髁突软骨及其修复组织进行大体形态学及组织学检查。结果 第1、2组实验动物的髁突软骨损伤区为纤维结缔组织增生,术后12周时,损伤区充满致密的纤维结缔组织,胶原纤维排列有序,与关节面平行。修复组织的质量类似,但第2组髁突软骨的退行性改变较第1组明显减轻。结论 泼尼松龙和透明质酸钠都能促进髁突软骨损伤后的修复,在预防颞下颌关节软骨的退行性改变方面,透明质酸钠优于泼尼松龙。     

经关节镜建立颞下颌关节面急性骨软骨缺损动物模型

目的　经微创手术制备颞下颌关节骨软骨缺损动物模型 ,以减少手术创伤对实验结果的影响。材料　经关节镜对 12只猕猴双侧关节上下腔进行关节面钻孔术 ,造成骨软骨缺损模型 ,对其缺损位置进行定位和记录。结果　 12只猕猴 2 4侧关节均在关节镜下进行了关节功能面的骨软骨缺损模型的建立 ,并进行了缺损部位的定位。结论　经关节镜建立猕猴关节面缺损模型是一种仅有微小创伤的方法 ,有助于减少手术本身造成的实验误差     

The collagen composition of the mandibular joint of the foetal calf

The distribution of genetically distinct collagen molecules in the mandibular joint was investigated. Type II collagen was found only in the articular cartilage. Both the fibrous layer covering the articular cartilage and the articular disc were composed of type I collagen and no type II collagen was detected. The histological appearance of these tissues was consistent with the biochemical findings. Small amounts of type III collagen were associated with the fibrous layer covering the articular cartilage; its function is unknown.     

Histological and immunohistochemical studies on the articular cartilage after experimental discectomy of the temporomandibular joint in rabbits

Total discectomy was performed experimentally in the rabbit temporomandibular joint (TMJ). In order to evaluate the injury and repair of the articular cartilage of the mandibular condyle after discectomy, both histologic and immunohistochemical observations were made. Immunohistochemical observation by using bromodeoxyuridine (BrdU) and its monoclonal antibody in vivo labelling method was used.
The present study demonstrated that the cartilage on the articular surface of the condyle disappeared at 1 week post-operatively. This defect in the injured articular cartilage was not repaired by the cartilage, but was covered by a fibrous connective tissue at 6 weeks post-operatively, where the condylar recontouring by the adjacent articular cartilage, and flattening and hyperplasia of the condyle were observed. Thus, the cartilaginous repair following discectomy was characterized by the proliferation of the adjacent cartilage to the injured site and osteoblastic formation in the bone marrow at the exposed subchondral bone.     

Autogenous auricular cartilage implantation following discectomy in the primate temporomandibular joint

The purpose of this study was to evaluate the histologic changes in primate temporomandibular joints (TMJ) treated with autogenous auricular cartilage grafts following total discectomy. Four Macaca fascicularis monkeys underwent bilateral TMJ disc removal and high condylar shaves. One TMJ in each monkey was treated by grafting autogenous auricular cartilage to the glenoid fossa; the contralateral joint served as a control. Monkeys were killed at 6, 12, 16, and 24 weeks postoperatively. Viable auricular cartilage was found in all grafted joints. There was a variable amount of fibrous connective tissue surrounding the cartilage grafts, with some grafts being directly fused to the glenoid fossa. One joint showed significant fibrous connective tissue adhesions between the condylar surface and the inferior portion of the graft. Degenerative changes in the grafted joint appeared grossly to be less severe than in the control joints. The cartilaginous tissues appeared to be a suitable autogenous tissue graft, maintaining its viability and functioning as an interpositioning material between the condyle and fossa.     

The effects of high molecular weight hyaluronic acid (Hylan G-F 20) on experimentally induced temporomandibular joint osteoartrosis: part II

The aim of this study was to determine the efficacy of Hylan G-F 20 on experimentally induced osteoarthritic changes in rabbit temporomandibular joint (TMJ). A 3 mg/ml concentration of sodium mono iodoacetate (MIA) had been injected into both joints of 24 rabbits to create osteoartrosis. The study group was injected with Hylan G-F 20 in one joint and saline in the contralateral joint as a control (once a week for 3 weeks). Histological changes in articular cartilage, osteochondral junction, chondrocyte appearance and subchondral bone were determined at 4, 6, and 8 weeks. Regarding cartilage, there was a statistically significant difference between the two groups at 4 weeks. Degenerative bony changes to subchondral bone were significantly higher in the controls. No statistical difference was found in the study group at 6 weeks. A positive correlation was found between osteochondral junction and subchondral bone in the study group at 8 weeks. The changes in chondrocyte appearance were significantly decreased in the study group at all follow-up times. Intra-articular injection of Hylan G-F 20 decreased cartilage changes in early stage TMJ osteoartrosis and clustering of chondrocytes showed the chondroprotective effects of Hylan G-F 20 caused by hypertrophic responses.