游离骨-骨膜修复关节软骨缺损的研究

Study on repair of defected articular cartilage with free osteoperiosteum

目的 观察自体游离骨 骨膜复合组织移植修复关节软骨缺损的组织形态学演变过程及其分期 ,探讨骨膜演化为软骨的影响因素 ,新生软骨退变的主要影响因素。方法 将健康家兔3 0只随机分为 6组 ,每组 5只。随机选择一侧足部跗骨切取骨 骨膜复合组织 2块 ,在双膝股骨髁间人为形成软骨及软骨下骨缺损 ,植入骨 骨膜块。结果 骨膜组织可演化为透明软骨组织 ,60个关节中 48个形成透明软骨 ,演变过程可分为 3期。结论 手术操作不得当对新生软骨的形成有不良影响。导致新生软骨早期退变的主要因素是未能注意修复的“完整性原则” ,及骨膜生发层朝向关节腔。

Objective To study the mechanism and the leading factor of cartilages evolution from self free osteoperiosteum and the causes of newborn cartilages disintegration,the evolution process and stages of morphology were observed in the repair of defected articular cartilage by transplanting complex tissue.Methods Thirty healthy rabbits were chosen and divided into 6 groups,5 for each,at random.Two pieces of osteoperiosteum complex tissue were resected form the tarsal bones of the randomly chosen one of the feet to make artificial defected cartilage and subcartilage between the condyles of femur on the both knees,where the two pieces of osteoperiosteum were implanted.Results Periost could survive and grow into hyaline cartilage.Hyaline cartilage was formed in 48 of 60 joints.The evolution process fell into 3 stages.Conclusion Proper operation technique plays an important role in the formation of cartilage and there are two causes of the early stage disintegration of newborn cartilage: (1) Little attention is paid to the integrative principle; (2) Cambium layer of periost faces articular cavity.