兔关节囊自体游离移植形成软骨的实验研究

The experimental study on the neochondrogenesis in free capsular autograft of rabbit

探讨兔髋关节囊移植化生软骨的可能性 ,为修复股骨头软骨缺损提供新材料。方法 :新西兰幼兔 2 4只 ,将其随机分成实验组 16只 ,取左髋关节囊 5mm× 5mm修复同侧股骨头软骨缺损 4mm× 4mm ;对照组 8只 ,仅造成左股骨头软骨缺损 4mm× 4mm。术后左髋进行持续被动活动 3周。这两组的右髋手术方法同实验组 ,术后让其自由活动 ,作为亚对照组。术后 6周及 12周处死动物 ,进行大体观察及组织学检查。结果 :实验组软骨形成率占 87.5 % (14/16 ) ,明显优于亚对照组的 2 9% (7/2 4) (χ2 =13 .0 99,P <0 .0 0 1) ,对照组无软骨形成。实验组及亚对照组 6周时 ,移植区表层可见滑膜细胞 ,深层为软骨细胞 ,12周时软骨细胞逐渐增多 ,对照组缺损区为纤维组织。结论 :兔髋关节囊移植可化生关节软骨 ,持续被动活动优于自由活动。关节囊游离移植在临床上的应用还需进一步研究。

Objective:To determine whether the neochondrogenesis may be induced in free intraarticular autografts of the hip. Methods:In 24 young rabbits. A 5mm × 5mm synovial capsule of the hip was cut and folded back on itself so that its deep (synovial) layer was facing. The grafts were transplanted to both ipsilateral femoral head which was done by completely chondrectomized articular surfaces (4mm × 4mm) of femoral head except 8 left hips (control group). The left hip of each rabbit was then placed in the continuous passive motion (CPM) apparatus for 3 weeks. The right hip regarded as subcontrol group was kept freely motion. Results:At the time of death (6 weeks and 12 weeks postoperatively), some degree of neochondrogenesis was more evident in 87.5% (14/16) of the grafts in the group with CPM than in 29% (7/24) of the grafts in the group without CPM (χ 2=13.099, P <0.001), and was not available in the control group. Cartilage cells was presented in 12 week more than in 6 week. Conclusion:This investigation showed that the chondrogenic potential of free capsular grafts was better under the stimulating effect of CPM than free motion.