自体骨髓间充质干细胞移植促进交叉韧带重建后腱骨愈合的研究

Autologous bone mesenchymal stem cell transplantation improves tendon-bone healing after anterior cruciate ligament reconstruction

目的探讨自体骨髓间充质干细胞对促进兔前交叉韧带重建后腱骨愈合的影响。方法采用骨髓穿刺法获取兔骨髓,体外分离、培养、扩增获得骨髓间充质干细胞。18只成年新西兰大白兔随机分为两组,每组9只,每只兔行双侧前交叉韧带重建手术,实验组将骨髓间充质干细胞和生物蛋白胶混合注入兔前交叉韧带重建模型的肌腱和骨道间隙内,对照组只注射生物蛋白胶,分别在2、4、8周各时间点每组处死3只兔子取材。组织学观察腱骨界面的愈合情况。结果对照组,术后8周在腱骨界面之间为瘢痕组织,腱-骨结合较紧密,有类Sharpey纤维成分。实验组,术后2周腱骨结合部位已经出现未成熟的类软骨细胞,术后8周为较成熟的软骨细胞,排列较整齐,从肌腱向骨道逐渐移行,类似于正常前交叉韧带的止点结构。结论前交叉韧带重建后,自体骨髓间充质干细胞移植于腱骨界面,形成类似正常前交叉韧带止点样结构,有利于促进腱骨愈合。

Objective To study the effect of autologous bone mesenchymal stem cell（bMSC） transplantation on tendon-bone healing after anterior cruciate ligament（ACL） reconstruction. Methods Bone marrow, harvested from rabbits by aspiration, was isolated and incubated in vitro to obtain bMSCs. Eighteen adult New Zealand rabbits were randomly divided into experimental group and control group（n=9）. Anterior cruciate ligament（ACL） was reconstructed. Rabbits in experimental group were injected with a mixture of bMSCs and fibrin glue via the space between tendon and bone channel, while those in control group were injected with only fibrin glue. Three rabbits were killed 2, 4, and 8 weeks after operation and samples were collected for histological observation of tendon- bone healing. Results Scar tissue with some Sharpey＇s-like fiber components on the tendon-bone interface and a close tendon-bone conjugation were observed in control group 8 weeks after operation. Immature and mature cartilage cells were found in tendon-bone junction of experimental group 2 and weeks after operation, respectively. The mature cartilage cells with a terminal-like structure of the normal ACL were regularly arranged and gradually migrated from the tendon to the bone channel. Conclusion bMSCs transplanted into the tendon-bone interface after ACL reconstruction can form a terminal-like structure of the normal ACL, thus speeding-up the tendon-bone healing.