孔数不同的骨钻孔术对兔软骨缺损远期修复效果的实验比较

Long-term effects of subchondral drilling with different holes in repair of articular cartilage defect in rabbits

目的: 评价孔数不同的钻孔术对软骨缺损的远期修复效果。方法: 用中国白兔40只, 在股骨髁关节面制造6mm×8mm全层软骨缺损, 分别施行10孔及5孔钻孔术, 孔径1mm, 于术后13个月取材做组织学及电镜观察,并进行评估。结果: (1) 10孔、5孔和对照组中, 优势修复组织为透明软骨者分别占75%、70%、0%。(2) 修复组织厚度: 10孔与5孔无显著性差异, 已接近毗邻软骨厚度。(3) 修复组织覆盖缺损的面积: 10孔>5孔>对照组。结论: 软骨下骨钻孔对关节软骨缺损的远期修复效果良好, 能长期适应关节的运动和负重, 10孔比5孔的修复效果好。

Objective:To evaluate the long-term effects on repair of articular cartilage defect after subchondral drilling with different holes.Method:Full-thickness defects (6mmX 8mm) were created in the articular surface of both the femoral condyles in 40 Chinese white rabbits.10 or 5 holes (diameter,1mm) were drilled respectively over the defects with the exception of control group.Rabbits were sacrificed postoperatively at 13 months.The newly formed tissues in the defects were examined under light and electron microscopes.The long-term effects of repair defect in different groups were compared and evaluated.Result:(1) The proportions of hyalin cartilage in the repair tissues were 75%,70% and 0% in the 10 holes,5 holes and control groups respectively.(2) The thickness of repair tissues had no significant difference between the 10 holes and 5 holes group and were near to the thickness of adjacent articular cartilage.(3)The covered areas of repair tissues of the 10 holes group exceeded those of the 5 holes and control ones.Conclusion:The long-term effects of subchondral bone drilling for repairing full-thickness articular cartilage defects are satisfactory,and the repair tissues have a long-term adaptation to joint movement and weight loading.Long-term effects of 10 holes is superior to that of 5 holes.