髋臼后壁重建后关节软骨修复的实验研究

目的 研究髋臼后壁重建区臼面软骨修复的组织学特点，初步探讨软骨柱播种在其修复中的作用。方法 选取12只家犬共24髋，随机分为3组，均采用后壁截骨法建立髋臼后壁60°弧1/2缺损的动物模型，两侧髋臼后壁缺损区分别选用不同的重建方法：A组：解剖重建+软骨柱播种，B组：解剖重建，C组：普通重建。术后12周取材进行大体形态、光镜观察，参照Pineda标准对新生组织进行评分。结果 A组中以成熟、新生类透明软骨修复缺损,B组为类纤维软骨修复，C组为纤维肉芽组织或板层骨修复。A、B、C组关节软骨修复Pineda总评分平均分别为(5.1±0.1)、(6.5±0.2)、(12.3±0.2)分，差异有统计学意义(F=3.157,P=0.000)，3组间两两比较差异均有统计学意义(P＜0.05)。结论 解剖重建促使部分软骨柱集中在缺损区，其修复组织具备部分关节软骨的组织特性，能够较好地替代关节软骨。

Healing and remodeling of articular cartilage after reconstruction of acetabular posterior wall

Objective To evaluate the efficacy of small cylindrical cartilage autografts in repairing articular cartilage defects of the reconstructed posterior wall on the basis of analysis of the pathological characteristics of the articular surface. MethodsIn this experiment, 12 canis familiaris had a survival surgery to make animal models of posterior acetabular defects which were reconstructed with iliac crest autografts. The 24 hips were divided into 3 groups randomly. In group A, the small cylindrical cartilage autografts were seeded into the cartilage defects to anatomically reconstruct the posterior wall. In group B, the cartilage defects were anatomically reconstructed. In group C (control group), the cartilage defects were conventionally reconstructed. The animals were sacrificed to harvest the hips after 12 weeks. The new tissues were assessed according to Pineda criteria and a histological comparison was made between the 3 groups.Results The repaired cartilages in group A belonged to hyaline-cartilage-like repair with characteristics of fibrocartilage and hyaline cartilage, but different from the adjourning normal cartilages. The repaired cartilage in the group B was morphologically similar to fibrocartilage cartilage whereas that in group C was fibrous tissue or lamellar bone repair. There were differences between the experimental groups and the control group, as well as between both experimental groups( P ＜ 0. 05 ) .Conclusions Anatomic reconstruction of the posterior wall may help repair the defects of articular cartilage. The small cylindrical cartilage autografts may distribute throughout the articular surface, providing an alternative method to repair articular cartilage defects.