论文部分内容阅读
目的采用自体游离骨膜移植修复幼兔关节软骨大面积缺损,并对其组织形态学进行观察,探讨髋关节软骨大面积缺损的修复方法。方法40只新西兰幼兔用利刀切除股骨头全层关节软骨达关节软骨表面积的20%以上,制成关节软骨大面积缺损模型。实验组取股骨全层游离骨膜,移植修复股骨头关节软骨缺损;对照组关节软骨缺损不作任何处理。于术后4、8、12、24周取股骨头关节软骨进行大体、光镜观察,Weston-blot法检测关节软骨缺损的修复组织中Ⅱ型胶原蛋白。结果骨膜移植24周后,肉眼下实验组关节软骨缺损区被透明、光滑的软骨覆盖,与周围正常关节软骨组织已难以区分。而对照组软骨缺损区在24周后仍清晰可见基底部少量暗红色纤维结缔组织。光镜下,实验组移植4周后软骨缺损区被骨膜再生组织完全填充,为幼稚透明软骨;12周后新生软骨细胞明显增多,逐渐成熟,但排列紊乱;24周后新生软骨排列趋于规则,与周围正常透明关节软骨结构相似,甲苯胺蓝呈异染性。对照组24周后软骨缺损区仍由纤维样组织覆盖,与周围正常组织分界清晰,边缘可见少量幼稚软骨细胞,甲苯胺蓝异染性不明显。通过Weston-blot法检测证实自体骨膜移植后第四周起,关节软骨缺损的修复组织中Ⅱ型胶原蛋白呈持续高度表达。结论自体游离骨膜移植于幼兔受损髋关节软骨,在一定条件下能演化形成关节透明软骨,可用于修复关节软骨大面积缺损。
Objective To repair the large area defect of rabbit articular cartilage with autologous free periosteal graft and to observe its histomorphology to explore the method of repairing the large area defect of hip cartilage. Methods Forty young New Zealand rabbits were given a knife to cut the full-thickness articular cartilage of the femoral head up to more than 20% of the articular cartilage surface area to make a large-area articular cartilage defect model. In the experimental group, the free periosteum of the femur was removed and the defect of the articular cartilage of the femoral head was repaired. The control group was treated with articular cartilage defect without any treatment. At 4, 8, 12, and 24 weeks after operation, the femoral articular cartilage was taken for gross and light microscopic examination. The type Ⅱ collagen in the repaired tissue of articular cartilage defect was detected by Weston-blot. Results After periosteal transplantation for 24 weeks, the articular cartilage defects in the experimental group were covered with clear and smooth cartilage, which was indistinguishable from the surrounding normal articular cartilage. The control group of cartilage defects in the area after 24 weeks still clearly visible a small amount of dark red basement fibrous connective tissue. Under light microscope, cartilage defect area was completely filled with periosteal regeneration tissue after 4 weeks transplantation in experimental group, which was naive hyaline cartilage. After 12 weeks, the number of newborn chondrocytes increased significantly and matured, but the arrangement was disorganized. After 24 weeks, , With the surrounding normal transparent articular cartilage structure similar toluidine blue heterochromatic. After 24 weeks, the cartilage defect area in the control group was still covered by fibrous tissue with a clear demarcation from the surrounding normal tissue. A small amount of juvenile chondrocytes could be seen at the periphery with no obvious toluidine blue stain. The results of Weston-blot showed that collagen type Ⅱ was continuously highly expressed in the repaired tissue of articular cartilage defect from the fourth week after autologous periosteum transplantation. CONCLUSION: Autologous free periosteum is implanted into the injured articular cartilage of young rabbits. Under certain conditions, it can evolve to form hyaline cartilage, which can be used to repair large area articular cartilage defects.