自体组织工程化纤维软骨修复半月板缺损的实验研究

目的：应用组织工程方法在具完全免疫功能的哺乳动物体内修复半月板缺损。方法：15只45日龄的长枫杂交仔猪为实验动物,以改良的Klagsbrun酶消化法从左膝半月板获得的自体纤维软骨细胞在体外扩增至一定数量,在右膝内侧副韧带前方的内侧半月板造成长1cm的全层缺损,分别将复合聚羟基乙酸（PGA）－纤维软骨细胞－Pluronic复合物,纤维软骨细胞－Pluronic复合物和单纯PGA植入缺损,以正常半月板和旷置缺损作为对照,分9,16和25周取材,标本采用大体观察,组织学,生物化学和生物力学作为评估指标。结果：PGA－细胞－Pluronic复合物在大体形态,组织学结构和压弹性模量（25周为正常组的59．7％）方面均显示形成了最佳的修复组织,并使对应股骨髁软骨的糖氨聚糖含量（25周为正常组的74．5％）保持相对稳定。结论：自体组织工程化纤维软骨能够修复乃至再造半月板,并且可以防止膝关节的创伤性退变。

Repair of meniscal defects with autologous tissue-engineered fibrocartilage

OBJECTIVE: To repair critical-sized meniscal defects in an immunocompetent mammal by tissue engineering approach. METHODS: 15 45-day-old Changfeng crossbred pigs were selected as experimental animals. Autologous fibrochondrocytes were obtained from left knee menisci by modified Klagsbrun's method and were proliferated in vitro to a proper amount. A 1-cm-long full-layer defect of right medial meniscus was created anterior to the medial collateral ligament. PGA-fibrochondrocyte-Pluronic complex, fibrochondrocyte-Pluronic complex or PGA only was respectively implanted into the defects. We used intact menisci and untreated meniscal defects as controls. Samples respectively obtained in 9 w, 16 w and 25 w were appraised by general observation, histology, biochemistry and biomechanics. RESULTS: From the sights of general morphology, histological structure and Young's Modulus (59.7% of that in normal meniscus at 25 w), the PGA-cell-Pluronic complex can form the best quality tissue, which can stabilize the GAG ratio (74.5% of that in normal cartilage at 25 w) of femoral entocondyle cartilage. CONCLUSION: Autologous tissue-engineered fibrocartilage is a promising feasible method to regenerate or reconstruct menisci so as to hold back the degenerative changes of the knee.