Lane J G, Tontz W L, Ball S T, Massie J B, Chen A C, Bae W C, Amiel M E, Sah R L, Amiel D
Department of Orthopaedics, Connective Tissue Biochemistry Laboratories, The University of California San Diego, La Jolla, California, USA.
Arthroscopy. 2001 Oct;17(8):856-63. doi: 10.1016/s0749-8063(01)90010-6.
The objective of this study was to assess the short-term changes that occur after an osteochondral autograft plug transfer from the femoral trochlea to the medial femoral condyle in a goat model.
Articular cartilage repair animal study.
Six adult male goats were used in this study. Two 4.5-mm osteochondral plugs were transferred from the superolateral femoral trochlea to 2 recipient sites in the central portion of the medial femoral condyle for a survival period of 12 weeks. Postmortem, the global effects of the procedure were assessed by gross morphologic inspection and by analyzing the synovial DNA for inflammatory response. The recipient sites were also evaluated histologically and biomechanically. Metabolic activity was determined by (35)SO(4) uptake, and viability was assessed using a live/dead stain and by confocal laser microscopy.
There was no evidence of significant gross morphologic or histologic changes in the operative knee as a result of the osteochondral donor or recipient sites. The patella, tibial plateau, and medial meniscus did not show any increased degenerative changes as a result of articulating against the donor or recipient sites of the osteochondral autografts. Analysis of synovial DNA revealed no inflammatory response. Biomechanically, 6- to 7-fold greater stiffness was noted in the cartilage of the transferred plugs compared with the control medial femoral condyle. Furthermore, on histologic examination, the healing subchondral bone interface at the recipient site had increased density. Glycosaminoglycan synthesis as determined by (35)SO(4) uptake was upregulated in the transplanted cartilage plug relative to the contralateral control, showing a repair response at the site of implantation. And finally, confocal microscopy showed 95% viability of the transferred plugs in the medial femoral condyle region.
Our findings demonstrate the ability to successfully transfer an osteochondral autograft plug with maintenance of chondrocyte cellular viability. The transferred cartilage is stiffer than the control medial femoral condyle cartilage, and there is concern regarding the increased trabecular mass in the healing subchondral plate, but these do not result in increased degenerative changes of the opposing articular surfaces in the short term.
本研究的目的是评估在山羊模型中，自体骨软骨栓从股骨滑车转移至股骨内侧髁后发生的短期变化。
关节软骨修复动物研究。
本研究使用了6只成年雄性山羊。将两个4.5毫米的骨软骨栓从股骨滑车的上外侧转移至股骨内侧髁中部的2个受体部位，存活期为12周。死后，通过大体形态学检查以及分析滑膜DNA的炎症反应来评估该手术的整体效果。还对受体部位进行了组织学和生物力学评估。通过（35）SO（4）摄取量来测定代谢活性，并使用活/死染色和共聚焦激光显微镜评估活力。
没有证据表明手术膝关节因骨软骨供体或受体部位而出现明显的大体形态或组织学变化。髌骨、胫骨平台和内侧半月板并未因与自体骨软骨移植的供体或受体部位接触而出现任何退行性变化增加的情况。滑膜DNA分析显示没有炎症反应。在生物力学方面，与对照的股骨内侧髁相比，转移栓的软骨刚度提高了6至7倍。此外，组织学检查发现，受体部位愈合的软骨下骨界面密度增加。相对于对侧对照，通过（35）SO（4）摄取量测定的移植软骨栓中的糖胺聚糖合成上调，表明植入部位出现修复反应。最后，共聚焦显微镜显示转移栓在股骨内侧髁区域的活力为95%。
我们的研究结果表明能够成功转移自体骨软骨栓并维持软骨细胞的活力。转移的软骨比对照的股骨内侧髁软骨更硬，并且愈合的软骨下板小梁质量增加令人担忧，但在短期内这些并未导致相对关节表面的退行性变化增加。
