Tibesku C O, Szuwart T, Kleffner T O, Schlegel P M, Jahn U R, Van Aken H, Fuchs S
Department of Orthopaedics, University Hospital Muenster, Albert-Schweitzer-Str. 33, 48129, Germany.
J Orthop Res. 2004 Nov;22(6):1210-4. doi: 10.1016/j.orthres.2004.03.020.
Autologous osteochondral grafting is a well-established clinical procedure to treat focal cartilage defects in patients, although basic research on this topic remains sparse. The aim of the current study was to evaluate (1) histological changes of transplanted hyaline cartilage of osteochondral grafts and (2) the tissue that connects the transplanted cartilage with the adjacent cartilage in a sheep model.
Both knee joints of four sheep were opened surgically and osteochondral grafts were harvested and simultaneously transplanted to the contralateral femoral condyle. The animals were sacrificed after three months and the received knee joints were evaluated histologically.
Histological evaluation showed a complete ingrowth of the osseous part of the osteochondral grafts. A healing or ingrowth at the level of the cartilage could not be observed. Histological evaluation of the transplanted grafts according to Mankin revealed significantly more and more severe signs of degeneration than the adjacent cartilage, such as cloning of chondrocytes and irregularities of the articular surface.
We found no connecting tissue between the transplanted and the adjacent cartilage and histological signs of degeneration of the transplanted hyaline cartilage. In the light of these findings, long-term results of autologous osteochondral grafts in human beings have to be followed critically.
自体骨软骨移植是一种成熟的治疗患者局灶性软骨缺损的临床手术,尽管关于该主题的基础研究仍然较少。本研究的目的是评估(1)骨软骨移植物中移植透明软骨的组织学变化,以及(2)在绵羊模型中连接移植软骨与相邻软骨的组织。
对四只绵羊的双侧膝关节进行手术切开,获取骨软骨移植物并同时移植到对侧股骨髁。三个月后处死动物,对接受移植的膝关节进行组织学评估。
组织学评估显示骨软骨移植物的骨部分完全长入。未观察到软骨水平的愈合或长入。根据曼金(Mankin)方法对移植移植物进行的组织学评估显示,与相邻软骨相比,退变的迹象明显更多且更严重,如软骨细胞克隆和关节表面不规则。
我们未发现移植软骨与相邻软骨之间的连接组织,以及移植透明软骨的组织学退变迹象。鉴于这些发现,必须密切关注人类自体骨软骨移植的长期结果。