自体骨软骨镶嵌移植修复猪膝关节骨软骨缺损

Autologous mosaicplasty osteochondral grafting to repair cartilaginous defects in pig

目的: 探讨猪自体骨软骨镶嵌移植治疗股骨负重区骨软骨复合缺损的优缺点。方法: 采用德国Arthrex公司OATS软骨移植器械, 进行长枫杂交仔猪同关节非负重区骨软骨移植修复负重区骨软骨缺损。结果: 12周后发现骨软骨柱移植后存活良好, 移植软骨中心区无明显凹陷及退变, 甚至稍有凸起, 质地同正常软骨; 与周围正常软骨界限仍清晰, 交界区软骨整合差, 有明显裂隙存在; 骨软骨供区有明显凹陷, 为白色组织充填, 质软, 周围可见正常软骨退变。结论: 自体骨软骨镶嵌移植具有移植软骨固定可靠、软骨细胞存活率高等优点, 但也有交界区整合差, 为纤维软骨修复等缺点。

Objective:To evaluate the possibility for the treatment of cartilaginous defects on the femoral bearing surface with autologous osteochondral transplantation in pigs.Method:The technique involved obtaining small cylindrical grafts from the non-weight bearing periphery of the knee,and transporting them to the femoral bearing surface using osteochondral auto-transplantation system (OATS) tools.Result:Specimens were harvested at the12~ th week after operation.The benefits of osteochondral auto-grafting included reliability of bone union and a high survival rate of the plugs.The disadvantages were poor integration and degeneration of circumference cartilage.Conclusion:Cartilage auto-grafts have several advantages over other methods including the stable fixation of auto-grafting plugs,a high survival rate of the grafted plugs and reliability of bone union,avoiding disease emission.But this method has drawbacks such as poor integration and degeneration so the authors want to combine the tissue engineering method with the mosaicplasty method to improve the curative effect.