自体骨膜延迟游离移植修复成年后关节软骨缺损的实验研究

The Repair of Grown-up Articular Cartilage Defect with Delayed Free Autogenous Periosteal Grafts:An Experimental Study.

目的 :研究年龄对自体骨膜游离移植修复关节软骨缺损的影响 ,探讨延迟游离移植能否提高成年后骨膜修复软骨能力。方法 :选中国白兔 ,成年兔 2 0只 ,幼兔 10只 ,分 3组。A组 :成年兔左膝骨膜直接游离移植组 ;B组 :成年兔右膝骨膜延迟游离移植组 ;C组 :幼兔骨膜直接游离移植组 ,取骨膜或骨膜新生组织、行光镜、电镜组织学观察比较。结果 :移植前B、C组骨膜厚度、细胞计数及细胞活跃程度均优于A组 (均为P <0 .0 1) ,移植后 12周 3组关节软骨缺损获得不同程度修复 ,C组优于A组 (P <0 .0 1)及B组 (P <0 .0 5 ) ,B组优于A组 (P <0 .0 1)。结论 :自体骨膜局部剥离、原位激活 ,体内培养、延迟游离移植可提高成年骨膜成软骨能力 。

Objective:To study the effect of age on repairing articular cartilage defect with free autogenous periosteal graft,and to investigate if the differentiation ability of the grown up periosteal was improved by delayed grafts.Methods:30 China white rabbits,including 20 adult rabbits(30 months)and 10 young rabbits(5 months)were divided into 3 groups according to 20 knee joints in every group.Group A:immediate free periosteal grafts in adult rabbits(left knee),Group B:delaycd free periosteal grafts in adult rabbits(right knee).Group C:immediate free periosteal grafts in young rabbits.The periosteal and repair tissues of different groups were observed through gross,histology and electronic microscope.Results:The periosteal of different groups were compared before graft,the thickness?cells number and active degree in group B and group C were superior to that in group A.( P <0.01).At 12 weeks after operation,all of defects were repaired in defferent degrees.The repair speed and quality of the repair tissue from different groups were compared,the result showed that the repair effect was excellent in group c,good in goup B,poor in group A.From statistical study,the difference was significant( P <0.01, P <0.05).Conclusion:The defects of articular cartilage were repaired with free autogenous periosteal in some degree.The periosteal of the young was active,so the defects was repaired sufficiently,otherwise the repaire was in sufficiently.The repair effect of the grown up articular cartilage defect was improved by delayed free periosteal grafts.