骨髓基质干细胞修复软骨缺损的实验研究

[目的]探寻体外诱导骨髓基质干细胞成软骨细胞的最佳细胞因子，寻求体内修复家兔软骨缺损的最为有效方案。[方法]rhFGF1、rhTGF-β1、rhIGF-1单独或联合应用对骨髓基质干细胞进行体外诱导培养，应用常规染色、MTT、免疫组织化学染色的方法筛选诱导骨髓基质干细胞成软骨细胞的最佳细胞因子，并将其与骨髓基质干细胞复合于纤维蛋白凝胶制成凝胶复合物，直接种植到兔膝关节实验性关节软骨缺损处，并与对照组相比较，观察软骨修复效果。[结果]常规形态学观察，rhTGF-β1和rhIGF-1联合应用诱导的细胞在形态上类似于软骨细胞，免疫组化染色提示诱导细胞具有软骨细胞表型。凝胶复合物直接种植在体内能诱导骨髓基质干细胞向软骨细胞分化，修复缺损的软骨，缺少细胞因子的对照组软骨缺损修复效果差。[结论]rhTGF-β1和rhIGF-1联合应用可作为诱导骨髓基质干细胞向软骨细胞分化的最佳组合，骨髓基质干细胞凝胶复合物能修复软骨缺损。     

骨软骨镶嵌成形术修复骨软骨复合缺损的比较研究

目的观察采用骨软骨镶嵌成形术（Mosaicplasty）修复膝关节中等和大面积骨软骨复合缺损的效果,为临床应用提供理论依据。方法24只成年山羊随机分成3组（n=8）。中等面积缺损组在股骨内髁制造直径6mm缺损,植入直径2mm骨软骨柱修复;大面积缺损组于股骨内髁制造9mm直径缺损,以直径3mm骨软骨柱修复;对照组于股骨内髁制造直径6mm缺损后不修复。自股骨髁间窝和滑车沟两侧非负重区用自制Mosaicplasty器械钻取骨软骨柱,推出器嵌入缺损处镶嵌填满。术后4、8、16及24周处死动物,取修复骨软骨组织行大体观察、HE及甲苯胺蓝染色。术后24周,取大面积缺损组和对照组膝关节摄X线片,观察骨软骨缺损修复情况,并分别取修复组织及正常软骨组织行蛋白聚糖（glycosaminogly cans,GAG）含量测定。结果中等面积缺损组术后4周,移植的骨软骨柱与基底部骨床结合牢固;8-24周软骨层之间以及与正常软骨间界限仍清晰。大面积缺损组术后4周,移植的骨软骨柱与基底骨床结合牢固,部分骨软骨柱被压入骨床内;8-24周压陷程度加重,与股骨髁相对关节面的部分软骨被磨损。对照组24周缺损仍无明显修复迹象,与股骨髁相对关节面的软骨磨损剥脱。组织学观察结果类似大体观察,术后24周中等及大面积缺损组软骨柱间均有缝隙存在,大面积缺损组毗邻软骨细胞稀疏肥大。术后24周,X线片可见大面积缺损组软骨下骨愈合良好,而对照组仍可见骨质缺损,与股骨髁相对关节面的软骨局部骨质硬化;软骨GAG含量测定显示正常软骨和大面积缺损组修复组织间差异无统计学意义（P〉0.05）;前两者与对照组修复组织比较,差异均有统计学差异（P〈0.05）。结论Mosaicplasty可修复中等面积骨软骨复合缺损,但无法有效修复大面积缺损,效果有待改进。     

自体骨软骨移植修复软骨缺损的研究

把非负重区正常软骨移植到负重区病损软骨部位，让其在受区发挥作用、改善关节功能、减轻患者痛苦是目前研究的热点。拟在关节镜监视下，取非负重区软骨自体移植替代负重区病变软骨．探讨自体骨软骨移植修复软骨缺损的可行性、效果及并发症。     

自体骨髓基质干细胞辅助Mosaicplasty技术促进骨软骨缺损修复整合

目的探讨以基于骨髓基质干细胞(BMSCs)的组织工程技术与自体骨软骨柱镶嵌移植术(Mosaicplasty)相结合的方法修复骨软骨及促进缺损间隙的整合效果。方法12只中国山羊于术前2周抽取骨髓,体外培养自体BMSCs。术中以自制器械分别制造山羊双后肢股骨内髁负重区直径5 mm、深3 mm的复合骨软骨缺损各一处。在Mosaicplasty技术填充缺损后,即以动物自体BMSCs与透明质酸凝胶相复合,注射填充于左后肢骨软骨柱之间及与周围组织的间隙内,右后肢单纯自体骨软骨柱移植作为对照组。术后第4、8、16周分别取材进行组织学、组织化学及蛋白聚糖含量等检测。比较16周时两组的缺损区惨复软骨组织与正常软骨的蛋白聚糖含量。结果两组自体骨软骨柱移植软骨均以透明软骨存活,与周围正常软骨间无明显差异。实验组骨软骨柱的间隙内可见新生软骨修复,组织学表现与周围正常软骨相同。交界区整合良好,间隙消失;对照组各时间点软骨间的间隙为纤维组织或纤维软骨填充,仍有间隙存留。移植软骨的基质、实验组骨软骨柱间隙内的新生软骨基质及Ⅱ型胶原免疫组化染色均为阳性。蛋白聚糖含量比较显示,对照组骨软骨柱间隙内新生组织的蛋白聚糖含量均低于正常软骨和实验组,差异有显著性意义(P< 0．05)。结论基于BMSCs的组织工程技术结合Mosaicplasty技术,可以有效地促进骨软骨缺损间隙的整合,改善修复效果好,有望成为一种理想的促进骨软骨缺损修复的方法。     

壳聚糖/羟基磷灰石支架修复骨软骨缺损的实验研究

[目的] 探讨双层壳聚糖(chitosan CS)/羟基磷灰石复合支架(hydroxyapatite HA)修复兔骨软骨缺损的可行性.[方法] 采用冻干法和烧结法制作双层壳聚糖(CS)/羟基磷灰石(HA)复合支架,以骨髓间充质干细胞为种子细胞,运用纤维蛋白胶种植技术,以双层壳聚糖(CS)/羟基磷灰石(HA)复合支架为载体,修复骨软骨缺损,实验分3组,A组:BMSc 支架,B组:单纯支架,C组:未处理.将修复材料植入骨软骨缺损模型,分别于6、12周取材,进行大体观察,组织学检测,改良Wakitani法评分,经统计学处理,比较各组修复效果差异(P＜0.05).[结果] (1)CS/HA支架CS层孔隙率为76%± 5.01%,孔径为200～400 μm,平均为300 μm左右,孔相通性好,HA层孔隙率为72%± 4.23%,孔径为200～500 μm,平均为350 μm左右,孔相通性好,结合部结合好;(2)P2骨髓间充质干细胞较纯,扫描电镜观察MSCs附着在复合支架上.大体观察和组织学检测显示, A组基本修复软骨缺损,骨缺损有骨小梁长入.B、C组骨软骨缺损修复不良,组织学检测以纤维性组织或无新生组织形成,软骨及骨缺损均明显存在,改良Wakitani评分显示A组在6周、12周2个时间点的各项评分结果,均优于B、C组,且差异有统计学意义(P＜0.05).[结论] 双层壳聚糖(CS)/羟基磷灰石(HA)复合支架可作为骨软骨组织工程支架,结合BMSc可修复软骨与骨的缺损,重建关节的解剖结构和功能.     

软骨脱细胞基质-Ⅱ型胶原纳米支架复合BMSC修复兔关节软骨缺损的实验研究

目的 观察软骨脱细胞基质(Cartilage acellular extracellular matrix,CAEM)-Ⅱ型胶原(CollagenⅡ,COLⅡ)纳米支架,复合骨髓基质干细胞(Bone marrow stem cells,BMSCs)修复兔关节软骨缺损的效果。方法 CAEM和COLⅡ按质量比1∶1混合,通过静电纺丝技术制备组织工程纳米支架。将第二代BMSCs种植到该支架上,培养箱内静置2 h。12只日本大耳白兔随机分为实验组和对照组,将细胞支架复合物植入实验组兔膝关节软骨缺损处,对照组仅行膝关节软骨缺损建模。12周后实验动物取材,大体观察修复效果,并行HE染色、Ⅱ型胶原染色观察。结果 大体观察见实验组软骨缺损修复良好,对照组软骨缺损处由肉芽样组织充填。HE染色显示,实验组关节软骨缺损处可见软骨陷窝形成,对照组关节软骨缺损处仅有纤维组织充填。实验组修复区Ⅱ型胶原染色为阳性,对照组为阴性。结论 CAEM-COLⅡ纳米支架复合BMSC,对兔关节软骨缺损具有较好的修复能力,具有潜在的临床应用价值。     

孔数不同的软骨下骨钻孔术对兔软骨缺损修复的影响

目的：为了观察软骨缺损的修复过程，比较不同数目钻孔术对软骨缺损的修复效果。方法：用中国白兔２４只，在股骨关节面造成６ｍｍ×８ｍｍ全层软骨缺损，分别施行１０孔及５孔钻孔术，术后４、８周取材，做组织学及电镜观察，并进行评估。结果：（１）１０孔、５孔和对照组的优势修复组织分别以类透明软骨，类透明软骨加纤维软骨和纤维组织为主。（２）修复组织厚度１０孔及５孔无显著差异。（３）修复组织覆盖缺损的面积，１０孔＞５孔＞对照组。初步结论：软骨下骨钻孔可修复关节软骨全层缺损；多孔比少孔修复好；非钻孔的缺损修复效果较差。     

"双相"组织工程软骨修复兔关节骨软骨缺损

目的探讨“双相”异体骨基质明胶（bonematrixgelatin,BMG）作为组织工程软骨载体,与同体骨髓间充质干细胞（marrowmesenchymalstemcells,MSCs）结合,构建组织工程软骨修复兔关节骨软骨缺损的效果。方法4月龄新西兰兔32只,雌雄不限,体重2～3kg。①体外实验：取5只新西兰兔,处死后取髂骨和四肢骨,制备一侧松质骨,一侧皮质骨的“双相”异体BMG载体,扫描电镜观察。另取新西兰兔18只,抽取骨髓,分离MSCs并诱导成软骨分化;将诱导而来的软骨前体细胞与“双相”BMG载体复合构建组织工程软骨,分别于1、3和5周取材行Masson、PAS染色和扫描电镜观察。②体内实验：将抽取骨髓的18只及余下的9只新西兰兔制成双侧股骨内髁骨软骨缺损模型,将前期制备的组织工程软骨同体植入18只兔的右股骨内髁骨软骨缺损（A组）,左侧缺损移植异体BMG（B组）,其余9只双侧软骨缺损未予处理作为空白对照（C组）,分别于术后1、3和6个月取材,行大体、组织学和Ⅱ型胶原mRNA原位杂交观察,改良Wakitani法评分,比较各组修复效果差异。结果①体外实验：“双相”BMG松质骨面孔隙大小100-800μm,细胞于其中增生,形成富含细胞的软骨层;皮质骨面孔隙大小10～40pm,细胞层状覆盖于其表面,可作为起支撑作用的软骨下骨。②体内实验：A组术后1个月即可重建关节骨软骨缺损;修复软骨在观察期内逐渐变薄,但在6个月内始终保持关节面及软骨下骨结构完整。B、C组未能修复缺损,缺损周边软骨磨损加剧。改良Wakitani评分显示A组在3个时间点的各项评分结果,除6个月软骨厚度外,其它指标均优于B、C组,且差异有统计学意义（P〈0．01）。Ⅱ型胶原mRNA原位杂交显示,A组缺损区修复组织中细胞阳性染色率明显高于B、C组,且差异有统计学意义（P〈0．01）。结论“双相”异体BMG可作为组织工程软骨载体材料,其结合自体MSCs诱导的软骨前体细胞制备的组织工程软骨,可修复兔关节软骨和软骨下骨。     

软骨移植与软骨下骨钻孔修复全层关节软骨缺损的比较实验研究

目的 :评价软骨移植、软骨下骨钻孔修复关节软骨缺损的生物特性和效果差异。方法 :采用重复拉丁方设计 ,将 36只雄性新西兰大白兔按三个因素三个水平进行随机区组 ,对左右后肢按设计好的创面大小制造全层软骨缺损。软骨移植组将不同家兔关节软骨交换嵌入移植。钻孔组依创面大小制造孔直径、间距、深度相同的骨孔 ,深达松质骨。对照组缺损不作任何修复。术后 4、8、1 2周处死取材 ,分别进行大体观察、光镜观察、电镜观察 ,对观察指标进行量化统计学分析。结果 :(1 )两实验组在第 1 2周时均能以类透明软骨组织修复缺损 ,而对照组为纤维肉芽组织 ,统计学分析表明各组间有显著性差异 (P <0 .0 1 )。 (2 )光镜观察表明两种手术方法均能以软骨的方式修复缺损 ,软骨移植组无明显免疫排斥迹象 ,软骨细胞有活性 ,各组间有显著性差异 (P <0 .0 1 )。 (3)形态学分析表明 ,随时间延长 ,光密度与修复高度渐增 ,其中软骨移植组优于其他各组 (P <0 .0 1 )。 (4)随时间延长修复效果逐渐改善。小创面修复效果与中等创面间无明显差异。 (5)电镜观察表明 ,两种手术方法均有软骨细胞生成 ,细胞器发达。对照组符合纤维肉芽组织特征。结论 :(1 )软骨移植、钻孔均能以类透明软骨的结局修复关节软骨缺损 ,软骨细胞生物学特性类似     

软骨下骨钻孔修复关节软骨缺损的研究进展

本文阐述了关节软骨损伤的机制和软骨缺损的类型，软骨下骨钻地缺损修复的诱导作用及再生软骨的机制，影响软骨再生的因素等。     

Filling of osteochondral donor site defects. Experimental study with tricalcium phosphate cement and BMP-2

AIM: Osteochondral grafting procedures have developed into one of the preferred methods of treatment for focal osteochondral lesions, although the management of the donor site remains problematic. In this animal study, an attempt at sealing the donor site with a fully-resorbable tricalcium phosphate bone cement was evaluated. METHOD: Autologous osteochondral transplantation of the medial and lateral condyle was performed on the ovine knee using a standard operative protocol. The ensuing defect was filled with the original beta-TCP cement laterally, while medially the cement was augmented with 50 micro g BMP-2. Two groups, consisting of 10 sheep each, were evaluated after three and 6 months, respectively. RESULTS: The clinical evaluation of the specimens revealed an improved reconstruction of the joint surface following the application of the augmented biomaterial. Macroscopically, the superficial border of the original donor site could easily be outlined at both time periods in both groups. Solid osteointegration of the bone cement could be documented radiographically as early as three months following implantation. CONCLUSION: The beta-TCP bone cement represents a promising resorbable filler for osteochondral defects. The augmentation with BMP-2 seems to expedite the remodelling process and improve the surface reconstruction.     

脱细胞骨软骨支架复合自体骨髓间充质干细胞修复羊骨软骨缺损的研究

目的探讨脱细胞骨软骨支架接种自体骨髓间充质干细胞(BMSCs)修复羊骨软骨缺损效果,探索骨软骨缺损新的修复方式。方法制备直径为8mm骨软骨脱细胞支架,培养羊BMSCs,接种于骨软骨支架,制备羊负重区骨软骨缺损模型,分空白、空白支架及细胞支架复合物3组,每组4只羊,3个月后处死动物取标本行大体及组织学检测。结果修复羊负重区骨软骨缺损模型实验结果显示细胞支架复合修复组骨软骨有较好修复,空白支架组软骨下骨基本修复、软骨侧无明显修复,空白对照组未见明显修复,缺损边缘软骨退变。结论含骨软骨连接结构的脱细胞骨软骨支架接种种子细胞能较好的修复羊负重区骨软骨缺损。     

Treatment of focal osteochondral defects of the acetabulum with osteochondral allograft transplantation

To our knowledge, treatment of focal osteochondral defects of the acetabulum with osteochondral allograft transplantation has not been described. As with osteochondral lesions of other weight-bearing surfaces, these defects may lead to disabling pain and early degenerative changes. In older patients who fail nonoperative treatment, hip arthroplasty is a reliable option to obtain pain relief and restore function. However, in young and active patients, it may be advantageous to restore joint congruity biologically. The clinical success of osteochondral allograft transplantation in the femoral condyles has been well-documented, with over 25 years of experience. We propose similar treatment principles in the hip joint.This article presents the cases of a 24-year-old woman (patient 1) and a 32-year-old man (patient 2) with hip pain and dysfunction secondary to a focal osteochondral defect of the acetabulum. Both were treated with osteochondral allograft transplantation to the defect using a dowel technique. A magnetic resonance image at 18 months in both cases demonstrated incorporation of the allograft bone into the host acetabulum. At 24 months in patient 1 and 42 months in patient 2, radiographs showed no progressive osteoarthritis. Both patients' Hip Outcome Scores were 100 points each.Osteochondral allografts allow large areas to be resurfaced without donor site morbidity, and these grafts provide an immediate functional joint surface. Although it has not been proven in terms of long-term follow-up, we believe that osteochondral allograft transplantation for focal osteochondral defects of the acetabulum in young, active patients is a feasible option to restore joint congruity.     

3种方法修复关节软骨缺损生物力学的研究

目的评价骨软骨柱镶嵌移植、骨-骨膜柱镶嵌移植和Ⅱ型胶原骨形态发生蛋白(BMP)复合物3种方法修复关节软骨缺损的生物力学变化,为临床应用提供实验依据。方法将20只成年新西兰兔制成膝关节缺损模型,修复1组在缺损局部镶嵌移植骨软骨柱,修复2组为骨-骨膜柱,修复3组为Ⅱ型胶原BMP复合物,空白组软骨缺损处不作处理,另取4只兔作为正常对照。术后12周取材制成宽3mm、长5mm、厚0·5mm的条状试件进行单向拉伸试验、黏弹性蠕变和松弛试验,所得数据结果进行统计学分析。结果3种方法对关节软骨缺损修复的修复物应力-应变曲线、时间-应力曲线和时间-应变曲线都具有一定的黏弹性表现,与对照组比较差异具有显著性(P<0·01),但较正常组仍有差距(P<0·05),其中修复1组标本力学性能强于修复2组和修复3组(P<0·05)。结论骨软骨柱镶嵌移植、骨-骨膜柱镶嵌移植和Ⅱ型胶原BMP复合物3种方法对关节软骨缺损具有良好的修复作用,骨软骨柱移植近期效果最佳,而Ⅱ型胶原BMP复合物来源广泛,适合修复大面积的关节软骨缺损。     

Clinical results of osteochondral allografts in the treatment of osteochondral defects

There have been very few clinical reports on osteochondral allograft in Japan. In the allograft we did for osteochondral defects of the knee, seven fresh grafts and four frozen grafts were used. In six of the seven fresh grafts, the surface presented macroscopically and/or arthroscopically the appearance of almost complete normality. From the histological study of the cartilage for biopsy which was obtained from the fresh graft at postoperative fifteen months, the cell viability, though decreased in the superficial layer, was fairly normal and profusely produced proteoglycan stained with safranin-O in both the middle and the deep layers. The cell viability, however, was decreased remarkably or disappeared in all three layers in the biopsy cartilage taken from the frozen graft at over one year postoperatively. The eight of the eleven knees treated with the osteochondral allograft have preserved the joint space on one foot standing radiogram and revealed good function clinically.     

Repair of osteochondral defects with autogenous callo-osseous grafts

A new method of biological repair of osteochondral defects is presented. An osteochondral defect in the rabbit knee was reconstructed with an autogenous callo-osseous graft made of a superficial sheet of medullary fracture callus attached to a base of cancellous bone. The reparative tissues were evaluated for 24 weeks by histology, analysis of uronic acid contents, and immunohistochemical staining of collagen constituents. The callo-osseous graft provided significantly faster and better repair of the articular surface than an untreated defect or a callo-osseous graft in which the cells had been devitalized by irradiation prior to transplantation. The results indicate that the callo-osseous graft contributes to the repair process via providing both favorable extracellular matrices and pluripotential mesenchymal cells.     

同种异体软骨移植修复关节软骨缺损实验研究

目的 采用兔膝关节软骨标本经打孔梯度降温冻存后行同种异体移植,研究打孔梯度降温冻存对兔关节软骨的影响及其修复关节软骨缺损的效果.方法 自16只2月龄新西兰白兔膝关节股骨髌面取分别取3块骨软骨移植物,随机分为3组.Ⅰ组为实验组,在软骨上以3 mm×3 mm矩阵打孔,Ⅱ、Ⅲ组为对照组,不打孔.分别将软骨标本置于二甲基亚砜冷冻保护溶液中,并经梯度降温至-80℃(Ⅰ、Ⅱ组)或直接置于-80℃(Ⅲ组)保存1周,复温后移植到成年兔相应膝关节部位.术后分批处死动物,通过对移植物的大体形态学、组织学、免疫组化染色光镜观察,研究各组移植物保存效果的差异.结果 Ⅰ、Ⅱ组光镜观察结果明显优于Ⅲ组;Ⅰ组与Ⅱ组结果差异不明显,但Ⅰ组对中间层软骨组织的保护明显加强.结论 关节软骨的梯度降温冷冻保存效果明显优于快速降温冷冻保存,且关节软骨打孔冷冻保存对深层软骨细胞有一定的保护作用,可提高软骨细胞存活率,延缓移植软骨组织的退变过程.     

Tracing transduced cells in osteochondral defects

In this study the authors explored the feasibility of using transduced cells for gene therapy to induce healing of osteochondral defects. Both a mouse mesenchymal cell line and mixed rabbit adherent stromal cells were transduced with either liposomal transfection or retroviral transduction using a traceable gene. Transduction efficiency was more than 95% with the retroviral construct and expression was maintained for over 6 months of passage. The liposomal transfection led to a transient expression with an efficiency of 50%. The expression of osteochondral genes was diminished but preserved after transduction in vitro. Transduced rabbit cells were transplanted into osteochondral defects in rabbit femoral condyles. Cells transplanted in vivo could be detected for 4 weeks in the repair tissue. The authors' data demonstrate that mesenchymal cells from bone marrow, stably transduced with a traceable gene product, retain the bone and cartilage phenotype and can be followed in vivo after transplantation into cartilage defects.     

Repair of osteochondral defects with hyaluronan- and polyester-based scaffolds

OBJECTIVE: The natural repair of osteochondral defects can be enhanced with biocompatible, biodegradable materials that support the repair process. It is our hypothesis that hyaluronan-based scaffolds are superior to synthetic scaffolds because they provide biological cues. We tested this thesis by comparing two hyaluronan-based scaffolds [auto cross-linked polysaccharide polymer (ACP) and HYAFF-11] to polyester-based scaffolds [poly(DL-lactic-co-glycolic acid) (PLGA) and poly(L-lactic acid) (PLLA)] with similar pore size, porosity and degradation times. DESIGN: Fifty-four rabbits received bilateral osteochondral defects. One defect received a hyaluronan-based scaffold and the contralateral defect received the corresponding polyester-based scaffold. Rabbits were euthanized 4, 12 and 20 weeks after surgery and the condyles dissected and processed for histology. RESULTS: Only ACP-treated defects presented bone at the base of the defect at 4 weeks. At 12 weeks, only defects treated with rapidly dissolving implants (ACP and PLGA) presented bone reconstitution consistently, while bone was present in only one third of those treated with slowly dissolving scaffolds (HYAFF-11 and PLLA). After 20 weeks, the articular surface of PLGA-treated defects presented fibrillation more frequently than in ACP-treated defects. The surface of defects treated with slowly dissolving scaffolds presented more cracks and fissures. CONCLUSIONS: The degradation rate of the scaffolds is critical for the repair process. Slowly dissolving scaffolds sustain thicker cartilage at the surface but, it frequently presents cracks and discontinuities. These scaffolds also delay bone formation at the base of the defects. Hyaluronan-based scaffolds appear to allow faster cell infiltration leading to faster tissue formation. The degradation of ACP leads to rapid bone formation while the slow degradation of HYAFF-11 prolongs the presence of cartilage and delays endochondral bone formation.     

同种异体半月板联合骨软骨移植的实验研究

目的:探讨新鲜同种异体半月板骨软骨联合移植治疗胫骨平台毁损伤后骨关节炎的疗效。方法:成年新西兰大白兔36只,随机分为A、B、C3组,各12只。A组行右膝内侧半月板连同胫骨平台骨软骨移植,克氏针交叉固定骨块。B组行右膝内侧半月板移植,左膝内侧半月板取出制备新鲜冷冻半月板。C组行左膝内侧新鲜冷冻半月板移植。术后4、8、12周分批取材行大体观察、组织学检查和胫骨平台软骨氨基己糖(GAG)测定。结果:12周时A组移植胫骨平台软骨与B、C组半月板移植术后的内侧胫骨平台软骨氨基己糖含量差异无统计学意义;A、B组移植的半月板纤维软骨细胞数差异无统计学意义;A组半月板移植的纤维软骨细胞数多于C组。结论:新鲜同种异体半月板骨软骨联合移植能修复胫骨平台毁损伤。