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使用成骨蛋白-1(骨形态发生蛋白-7)修复犬关节软骨缺损。

Repair of articular cartilage defects with osteogenic protein-1 (BMP-7) in dogs.

作者信息

Cook Stephen D, Patron Laura P, Salkeld Samantha L, Rueger David C

机构信息

Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA 70112, USA.

出版信息

J Bone Joint Surg Am. 2003;85-A Suppl 3:116-23. doi: 10.2106/00004623-200300003-00018.

Abstract

BACKGROUND

Articular cartilage injury has a poor prognosis for repair. Mesenchymal cells, when exposed to osteogenic proteins and other cytokines, can differentiate into cells that behave phenotypically as chondrocytes. In this study, we examined the ability of recombinant human osteogenic protein-1 (rhOP-1 or rhBMP-7) to elicit the repair of osteochondral defects in dogs.

METHODS

Bilateral osteochondral defects that were 5 mm in diameter by 6 mm deep were surgically created in the medial femoral condyles of sixty-five adult dogs. rhOP-1-treated (100 mg of a 3.5-mg rhOP-1/g bovine bone-derived Type-I collagen device) and control defects (untreated or treated with 100 mg bovine bone-derived collagen implants) were evaluated grossly and histologically at six, twelve, sixteen, twenty-six, and fifty-two weeks postoperatively. The influence of protected initial weight-bearing and surgical placement of periosteal flaps was also evaluated.

RESULTS

Gross and histologic grading of the defect repair indicated improvement in the rhOP-1-treated defects compared with that in the controls. Grossly, the repair tissue in the rhOP-1-treated defects was continuous with the adjacent intact cartilage and appeared translucent. By comparison, the repair tissue in the control defects was discontinuous and opaque or inhomogeneous in nature. Histologically, maturing cartilage similar in appearance to the intact articular cartilage was present in the rhOP-1-treated defects. Cartilage at the defect interface was minimally degraded. The control defects were filled primarily with fibrous tissue and fibrocartilage. Significant differences based upon treatment type were observed at twelve weeks, sixteen weeks, and for all time-periods combined (p = 0.0385, p = 0.0070, and p = 0.0026, respectively).

CONCLUSION

rhOP-1 (rhBMP-7) induced hyaline cartilage-like repair of full-thickness osteochondral defects in a dog model. Differences in cartilage repair were maintained at fifty-two weeks postoperatively with no significant degradation of the rhOP-1-induced repair tissue.

摘要

背景

关节软骨损伤的修复预后较差。间充质细胞在接触成骨蛋白和其他细胞因子时,可分化为表型上类似软骨细胞的细胞。在本研究中,我们检测了重组人成骨蛋白-1(rhOP-1或rhBMP-7)诱导犬骨软骨缺损修复的能力。

方法

在65只成年犬的内侧股骨髁上手术制造直径5mm、深6mm的双侧骨软骨缺损。对rhOP-1治疗组(使用含3.5mg rhOP-1/g牛骨来源I型胶原装置,剂量为100mg)和对照组缺损(未治疗或使用100mg牛骨来源胶原植入物治疗)在术后6周、12周、16周、26周和52周进行大体和组织学评估。还评估了保护性初始负重和骨膜瓣手术放置的影响。

结果

缺损修复的大体和组织学分级显示,与对照组相比,rhOP-1治疗组的缺损有改善。大体上,rhOP-1治疗组缺损处的修复组织与相邻完整软骨连续,呈半透明状。相比之下,对照组缺损处的修复组织不连续,性质为不透明或不均匀。组织学上,rhOP-1治疗组缺损处存在外观与完整关节软骨相似的成熟软骨。缺损界面处的软骨降解轻微。对照组缺损主要由纤维组织和纤维软骨填充。在12周、16周以及所有时间段综合比较时观察到基于治疗类型的显著差异(分别为p = 0.0385、p = 0.0070和p = 0.0026)。

结论

rhOP-1(rhBMP-7)在犬模型中诱导了全层骨软骨缺损的透明软骨样修复。术后52周软骨修复的差异持续存在,rhOP-1诱导的修复组织无明显降解。

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