同种异体肋软骨膜移植半月板再生的实验研究

An Experimental Study of Rib Perichondrial Allograft for Meniscal Regeneration in Dogs

目的 :探究同种异体肋软骨膜游离移植再生半月板的能力及其预防关节退变的意义。材料及方法 :选用成年家犬 10只 ,双膝关节内侧半月板切除后随机选取一侧膝关节内侧间隙植入同种异体肋软骨膜 (同种异体移植组 ) ,对侧膝关节植入自体肋软骨膜 (自体移植组 ) ,以全部切除的正常半月板及正常膝关节作为对照 (对照组 )。分别于术后 4、8、12周切取标本 ,进行大体、光镜 (HE染色及Alcian blue、Safranin 0复染 )、透射电镜观察 ,并对正常半月板及术后 12周的移植物进行生物力学测试。结果 :12周时所有移植物都衍化再生出接近正常半月板大小及形态的纤维软骨板。在整个实验过程中未见明显的免疫排斥反应。生物力学测试结果显示两移植组再生半月板的抗拉伸性能无显著性差异 ,均低于正常半月板。结论 :同种异体肋软骨膜游离移植于半月板缺失的犬的膝关节中可以存活 ,并可再生出接近正常形态、结构的半月板 ,无免疫排斥反应。

Objective: To examine the potential of perichondrial allografts to form new menisci.Methods:Total medial meniscectomies were performed in all hind knees of 10 mature family dogs.In each dog one knee was transplanted with a free rib perichodrial allograft randmly (group r),the other knee was transplanted with a free rib autogroft (group T).All the excised normal menisci served as control(group Z).The grafts and the articular cartilage were removed at 4,8 and 12 weeks respectively and studied by macroscopic examination,light microscopy and electron microscopy.The grafts of 12 weeks and the normal menisci also underwent biomechanical tests.Results:At 12 weeks all transplants developed into mature fibrocartilage plates which were similar to normal menisci in size and shape.The result of biomechanical tests showed that there was no significant difference in the failure stress of the regenerated menisci between group Y and group T,which were both lower than that of normal menisci.Conclusion:In dogs the free rib perichondrial allografts,after being transplanted into the knees of medial meniscectomy,were able to survive without immune response and form new menisci similar to normal menisci in shape and construction.