自体骨软骨移植与含富集骨髓干细胞松质骨移植修复兔关节软骨缺损

目的:评价自体骨软骨移植与含富集骨髓干细胞松质骨镶嵌移植两种方法修复全层关节软骨缺损的生物学特征和效果。方法:采用新西兰大白兔制作左右后肢全层软骨缺损模型,分别进行自体骨软骨镶嵌移植、含富集骨髓干细胞松质骨镶嵌移植修复,对照组不作任何修复,每组12只。术后第4、8、12周处死动物取材,分别进行膝关节活动度测定、大体观察、光镜观察与电镜观察。结果:移植实验组在第12周时均能以类透明软骨组织修复缺损,对照组为纤维肉芽组织。形态学检查表明,两种方法均能以类透明软骨组织覆盖缺损,骨软骨移植组无明显免疫排斥现象,随着时间延长,修复高度逐渐增加。骨软骨移植组同含富集骨髓干细胞松质骨镶嵌移植组效果无显著差别。结论:骨软骨移植、含富集骨髓干细胞松质骨镶嵌移植两种方法均能以类透明软骨组织修复全层关节软骨缺损,含富集骨髓干细胞松质骨镶嵌移植更适用于较大面积软骨缺损的修复。

Experiment on Large Area Articular Cartilage Defect Repaired with Autologous Osteochondral Grafits or Cancellous Bone Enriching Bone Marrow Stem Cells

Objective To compare and evaluate the differences of potentialities and biological characteristics between autologous ostreochondral and cancellous bone enriching bone marrow stem cells in a large area defects of articular cartilage in weight-bearing joints. Methods By using the completely random design one-way ANOVA, 36 adult rabbits were divided into 3 groups randomly. Autologous cartilage transplant and cancellous bone enriching bone marrow stem cells transplant were applied for repairing of size-mached, full-thickness articular cartilage defect on the femoral condyle of the knees. The reconstructed tissues were observed by gross, optical and electronic microscopic view and analyzed morphologically at 4,8,12 weeks respectively. Results Both methods could repair the lesions by hyaline-like cartilage at 12 weeks, while in the control group it was filled with fibrous tissue. The height of the repairing tissue compared with the normal cartilage and the light density data indicated that the cartilage transplant group was similar with cancellous bone enriching bone marrow stem cells transplant and better than the control group as well. Conclusion Autologous osteochondral transplant and cancellous bone enriching bone marrow stem cells transplant are feasible for repairing of the large area articular cartilage defects.