组织工程软骨修复兔半月板损伤(英文)

Repair of meniscus injury with tissue engineered cartilage in rabbits

背景:半月板游离缘为无血运区,损伤不易自然愈合,需要在一定的条件促进下产生纤维组织愈合。目的:采用组织工程软骨与纤维蛋白黏合剂治疗半月板无血运区的损伤,并进行的效果比较。设计:随机分组,空白对照实验。单位:深圳市第二人民医院动物实验室。对象:①选择生后3～5d青紫兰兔10只用于纤维软骨细胞的提取。②选择健康成年青紫兰兔36只,随机分为3组,空白对照组、纤维蛋白黏合剂治疗组和组织工程软骨组,每组12只。方法:实验于2003-09/2004-03深圳市第二人民医院动物实验室完成。将10只生后3～5d幼兔处死后提取纤维软骨细胞进行培养,制成软骨细胞含量约为12×108L-1的组织工程软骨。将36只成年兔造成半月板(0.7×0.3)cm全层裂伤的无血运区损伤模型。空白对照组裂伤不用任何填塞处理,纤维蛋白黏合剂治疗组用纤维蛋白黏合剂注入裂口,组织工程软骨组用组织工程软骨注入裂口。3组动物分别于术后2,6,12周各处死4只,每次每组取8个半月板,行大体形态观察和组织学检查。主要观察指标:兔半月板损伤模型标本大体形态观察和组织学检查。结果:36只兔均进入结果分析。①兔半月板损伤模型标本大体观察结果:空白对照组半月板损伤裂口均未愈合,未见组织填充;纤维蛋白黏合剂组及组织工程软骨组的全部半月板伤口均已被组织填充。②兔半月板损伤模型标本组织学检查结果:空白对照组术后2～12周裂口边缘无软骨细胞增殖;纤维蛋白黏合剂组术后12周,缺损边缘有较多的成纤维细胞样细胞,与邻近组织连接较紧密,形成瘢痕组织愈合;组织工程软骨组术后12周,缺损处可见软骨陷窝及软骨囊,软骨细胞成团状。结论:组织工程软骨在受体内可成活,可形成纤维软骨样愈合,形成软骨细胞特有的生物学标志,但修复的组织与邻近正常半月板组织及正常软骨的胶原排列有明显差异。

BACKGROUND: The free border of meniscus is avascular portion, for which, it i s not susceptible for the meniscus to be cured naturally after injury. Therefore , it is necessary to induce fibrous tissue healing probably under certain situat ion. OBJECTIVE: To adopt tissue engineered cartilage and fibrin adhesive to treat meniscus injury in avascular portion and compare the results. DESIGN: Randomized group division and blank control experiment was designed. SETTING: Animal Laboratory of a Shenzhen Second People's Hospital. MATERIALS: ① Ten green- purplish- blue rabbits in 3 to 6 days after birth were selected for extraction of fibrochondrocytes. ② Thirty- six green- pur plish- blue adult rabbits were selected, randomized into 3 groups,12 rabbits in each, named blank control, fibrin adhesive group(FA group) and tissue engineere d cartilage group(TE- C group). METHODS: The experiment was performed in Animal Laboratory of Shenzhen Second People's Hospital from September 2003 to March 2004. Ten baby rabbits borne in 3 to 5 days were sacrificed to collect fibrochondrocytes for culture so as to pr epare tissue engineered cartilage containing 12× 108 L- 1chondrocytes.Thirty- six adult rabbits were prepared into the injured model in avascular portion of meniscus (0.7× 0.3) cm with full- thickness laceration. In blank control, no a ny filler was applied for management; in FA group, fibrin adhesive was infused i n laceration; and in TE- C group,tissue engineered cartilage was infused in lac eration.Four animals of each of 3 groups were sacrificed in the 2nd, 6th and 12t h weeks after operation.Eight menisci were collected in each group each time for gross morphological observation and histological examination. MAIN OUTCOME MEASURES:Gross morphological observation and histological examin ation in injured meniscus model of rabbit. RESULTS:Thirty- six rabbits all entered result analysis.① Gross morphologi cal observation in injured meniscus model of rabbit: In blank control, the split s in meniscus were not been healed and tissue filler was not apparent.In FA and TE- C groups, the splits had been filled up with tissue fillers completely.② Histological examination in injured meniscus model of rabbit:In blank control, 2 to 12 weeks after operation, there was chondrocyte proliferation presented on t he border of splits.In FA group,12 weeks after operation, on the defect border, there were many fibroblastic cells that closely adhered to adjacent tissue,resul ting in scar tissue healing.In TE- C group, 12 weeks after operation, cartilage cavities and capsule were apparent in the defect and chondrocytes were in cell condensation. CONCLUSION:Tissue engineered cartilage is survived in the acceptors, resultin g in fibrocartilaginous healing and specific biological label of chondrocytes.Bu t the remarkable difference presents in collagen arrangement among the repaired tissue,adjacent normal meniscus tissue and normal cartilage.