自体骨膜移植修复关节软骨缺损生发层不同朝向的比较研究

COMPARISION BETWEEN THE DIFFERENT FACING DIRECTIONS OF GERMINAL LAYER OF PERIOSTEUM IN REPAIRING ARTICULAR CARTILAGE DEFECT /

为了观察骨膜再生软骨中，骨膜生发层不同的朝向是否影响软骨再生。应用人体纤维蛋白粘合剂粘合自体骨膜修复兔关节软骨缺损，对移植骨膜生发层不同朝向（即朝向关节腔或软骨下骨）的差别进行比较。结果表明：６周前，朝向关节腔组增殖较快，６周后两组无明显差别，故生发层的朝向不是一个重要影响因素。另外，应用藏红Ｏ蛋白多糖染色的电镜观察，证实两组再生软骨均为透明软骨。

In order to observe the effects of different facing directions of the germinal layer of periosteum on the cartilage regeneration, the human fibrin adhesive agent was used to adhere autogenous periosteum to repair the articular cartilage defect of rabbits. Twenty four rabbits with 48 knee joints were divided randomly into two groups. A 0.6cm×1.2cm articular cartilage defect was created on the femoral trochlea until there was bleeding from the subchondral bone. A piece of periosteum, sized 0.75cm×1.5cm, was removed from the medial aspect of upper tibia. The periosteum was adhered to the defect by human fibrin adhesive agent. In Group 1 the germinal layer faced the subchondral bone and in Group 2 the germinal layer faced the joint cavity. The cartilage regeneration in both groups was observed by naked eyes and light microscope in 2nd and 6th weeks and by electron microscope after Safronin O stained in 12th and 20th weeks. The results showed that before the 6th week, the cartilage regeneration was faster in Group 2 than that in Group 1. After that there was no significant difference in regeneration between the two groups. This suggested that the facing direction of the germinal layer was not a critical factor on cartilage regeneration. It was also found that the strength of the adhesive agent was not enough. The regenerated cartilage was proved to be hyaline cartilage.