关节软骨的损伤及其修复现状

Current research situation of arthroidal cartilage injury and repair

背景:关节软骨一旦损伤,则遗留永久性病变,且软骨组织自愈能力非常有限,治疗比较困难。目的:综述国内外关于关节软骨损伤及其修复现状的研究概况。方法:计算机检索中国生物医学文献数据库、中文科技期刊全文数据库、中文学术期刊全文数据库及PubMed、EMbase数据库1990-01/2009-09期间的相关文章,检索词为"关节软骨损伤,关节软骨损伤,arthroidal cartilage injury,arthroidal cartilage repair。此外还手工查阅相关专著数部。纳入关节软骨结构的研究、关节软骨损伤机制的研究、关节软骨细胞移植修复的研究、关节软骨组织工程修复的研究类文章。结果与结论:传统的软骨修复方法主要包括软骨下钻孔术、磨削术和微骨折术等,其目的是动员具有成软骨潜能的各类细胞增殖分化,从而达到修复重建的目的。但因修复的组织往往为纤维软骨,而非透明软骨,且存在进一步退化及二期骨化等问题,故总体效果不佳。近年来,随着材料学、细胞生物学、工程学以及相关物理、化学学科的发展和交叉,如软骨移植、组织细胞工程以及基因治疗等各种新的关节软骨缺损修复方法逐渐被研发应用。

BACKGROUND：The cartilage injury is difficult to treat due to its limited self healing ability.OBJECTIVE：To review the current situation research of arthroidal cartilage injury and repair.METHODS：The databases of Chinese Biomedical Literature Database,CNKI,China Academic Journals Full-text Database,PubMed,EMbase were retrieved with key words of ＂arthroidal cartilage injury,arthroidal cartilage repair＂ for articles published from January 1990 to September 2009.The language was limited to Chinese and English.Papers concerning structure of articular cartilage,mechanism of articular cartilage injury,repairing the articular cartilage injury with articular cartilage transplantation,as well as using tissue engineering methods to regenerate articular cartilage were included.RESULTS AND CONCLUSION：The traditional cartilage repair methods mainly include subchondral drilling,grinding and micro fracture art,with purpose of mobilizing all the cell proliferation,which has the potential to proliferate cartilage cells,so as to achieve the objective reconstruction.However,the repairing tissues are often fibrocartilage,rather than transparent cartilage.Further degradation and the general problems such as the ossification also exist so general therapeutic effects were poor.In recent years,with the material science,engineering,and cell biology,physics and chemistry disciplines related to the development and cross,new kinds of articular cartilage repair defects,such as cartilage cells transplantation,tissue engineering and gene therapy,is gradually applied.