牵引成骨结合组织工程化软骨重建山羊髁突缺损的实验研究

目的：利用牵引成骨结合组织工程化软骨重建山羊髁突缺损。方法：12只山羊随机分为两组：实验组在下颌切迹下方作截骨线,切除一侧髁突及其颈部,左右随机。再于下颌支后缘形成转移盘,在转移盘的远中植入软骨细胞支架复合物。对照组在转移盘的远中仅植入支架。分别于牵引结束4、8、12周大体及组织学观察山羊髁突的形成情况。结果：牵引结束后4周,实验组山羊髁突已具备良好的外形,髁突表面覆盖软骨组织：对照组山羊新形成之髁突外形虽与正常髁突相似但表面无软骨层。12周时,实验组山羊髁突外形与正常髁突相似,表面仍有软骨层覆盖：而对照组山羊新形成的髁突外形虽与正常髁突相似,但表面仍无软骨层覆盖。结论：利用牵引成骨结合组织工程化软骨的方法不仅可以从外形上重建山羊髁突,而且在解剖结构上与正常髁突相似,为髁突正常功能的行使提供了良好的解剖学基础。

Experimental study on reconstruction of goat condylar defect using distraction osteogenesis combined with tissue engineered cartilage

PURPOSE: The aim of this study was to reconstruct the condylar defect by distraction osteogenesis (DO) and tissue engineered (TE) cartilage in goats. METHODS: 12 goats were divided randomly into 2 groups, 9 goats in the experimental group and 3 in the control group. In the experimental group, the mandibular condyle of one side was surgically removed and a transport disc was made, implantation of scaffold and chondrocytes compounds on the distal surface of the transport disc was performed. In the control group, implantation of scaffold alone on the distal surface of the transport disc was performed. After a five-day latent period, the distraction was activated at a rate of 1mm per day, until a certain height was achieved. All goats were in a normal diet after surgery. 3 goats were sacrificed at 4 weeks, 8 weeks and 12 weeks in the experimental group and 1 in the control group postoperatively, and the specimen of the condyle were studied radiographically and pathohistologically. RESULTS: The shape of the new formed condyles from all experimental goats were similar to the normal ones morphologically and histologically. While, in the control group, the new formed condyles were similar to the normal ones morphologically, but with no cartilage on the surface of the condyle. The results from the 4th, 8th and 12th week were similar. CONCLUSION: The new condyles reconstructed with DO and TE cartilage are similar to the normal both morphologically and histologically. Therefore, distraction osteogenesis with TE cartilage implantation could be an ideal way to reconstruct condylar defect.Supported by National "863" Project(Grant No. 2002AA205011),Research Fund of Shanghai Municipal Education Commission(Grant No. 01BZ02) and Post-phosphor Program of Shanghai Municipal Education Commission(Grant No. 06QH14009).