兔关节软骨损伤的修复与重建

The repair and remodeling of rabbit articular cartilaginous injury

目的:研究关节内骨折错位时不同纵向错位程度及运动方式对关节运动功能的恢复及关节软骨损伤修复的影响。方法:建立兔膝关节股骨内侧髁全厚(0.5mm)及两倍厚(1.0mm)关节软骨的骨折错位模型,分别对这些实验动物膝关节采用外固定、间歇性主动活动、持续性被动活动3种方法处理。在12周时,利用活体观测,并用光学显微镜和透射电镜对关节骨折错位的治疗和重建进行研究。结果:患膝关节活动范围,持续被动运动组和间断主动运动组之间差别不明显,二者均好于制动组。光学显微镜下,制动组1.0mm错位的兔膝关节软骨退变最明显。0.5mm错位组修复组织为类透明软骨;而1.0mm错位组修复组织则为纤维软骨,透射电镜发现,0.5mm错位组较1.0mm错位组修复组织软骨细胞更为成熟,细胞器丰富,细胞间纤维组织含量少。结论:兔膝关节内骨折错位的修复组织性质与错位的程度有关。运动有利于关节软骨损伤的修复,对关节运动功能的恢复有积极作用。

Objective:To study effects of longitudinal fracture with step-off in different extent and the different motive patterns on healing of articular cartilaginous injury.Method:Two kinds of intra-articular step-off models,0.5mm and1.0mm,are established and treated with either immobilization for three weeks,intermittent active motion,or continuous passive motion for seven days.At twelve weeks,the healing and remodeling of the intra-articular fracture with step-off defect are examined with use of gross,LM and TEM observation.Result:There were no significant differences of motive range between continuous passive motion groups and intermittent active motion groups,but the motive range of the two groups were better than that of immobilization groups.LM observation:The animals in all experimental groups at twelve weeks showed arthrochondritis degeneration in different extent with1.0mm step-off immobilization groups being the largest.Among all the experimental animal groups,repaired tissue was hyaline cartilaginoid in0.5mm step-off groups,but fibrous cartilage in1.0mm step-off groups.TEM observation:With0.5mm step-off groups,the chondrocytes of the repaired were more developed,the number of cellular organs were richer,and less fibrous tissue among cells.Conclusion:The repairing and remodeling tissue of intra-articular fracture with step-off is closely related to the extent of the step-off.Movement exerted some a bit effects on the healing of articular cartilaginous injury,and active effects on the repairing of articular motive function.