自体骨软骨移植联合富集BMSC-PLGA复合物修复猪膝关节软骨缺损

Autologous osteochondral mosaicplasty combined with enriched BMSC-PLGA composite repairs cartilage defects in porcine knees

目的探讨运用自体骨软骨移植联合富集骨髓间充质干细胞-聚乳酸羟基乙酸共聚体(BMSC-PLGA)复合物修复猪膝关节软骨缺损的疗效。方法在12只小型猪的双侧膝关节股骨内髁建立陈旧性软骨缺损模型,并将这24例膝关节随机均分为对照(A)组和复合物(B)组。两组缺损首先运用自体骨软骨移植修复,B组多个移植物之间遗留的死腔再使用富集BMSC-PLGA复合物填塞。术后6个月,通过大体观察、组织学和生物力学评价修复效果。结果在大体观察和组织学评估中,B组的各项得分均高于A组(P<0.05)。B组的弹性模量明显高于A组(36.2MPa vs.26.9MPa)(P<0.05)。结论运用自体骨软骨移植联合富集BMSC-PLGA复合物修复膝软骨缺损的效果明显优于单纯运用自体骨软骨移植的修复效果。

Objective To investigate the curative effect of autologous osteochondral mosaieplasty combined with enriched bone marrow stroma cell （BMSC）-poly （lactideco-glycolide） （PLGA） composite on repairing articular cartilage defects in porcine knees. Methods A standardized full-thickness defect was created in the weight-bearing area of each medial femoral condyle in both knees of 12 miniature pigs. A total of 24 knees was equally randomized into group A（control） and group B（BMSC-PLGA composite）. The defects in both groups were initially repaired by autologous osteochondra[ mosaicplasty. Then any dead space between the multiple plugs was filled with enriched BMSC-PLGA composite in group B or left untreated in group A. Six months after surgery, the repair results were estimated by macroscopic observation, histological evaluation and biomechanical assessment. Results Compared with group A, the scores were significantly higher in all the categories of macroscopic observation and histological evaluation in group B （P〈0. 05 ）. The compressive modulus in group B was higher than that in group A（36.2 MPa vs. 26.9 MPa） （P〈0. 05）. Conclusion Utilizing mosaicplasty combined with enriched BMSC-PLGA composite to repair cartilage defects achieves a better result than that of single mosaicplasty.