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机械性软骨成形术:体外早期代谢后果

Mechanical chondroplasty: early metabolic consequences in vitro.

作者信息

Kaplan Lee D, Royce Bryan, Meier Brian, Hoffmann Justin M, Barlow Jonathan D, Lu Yan, Stampfli Herman F

机构信息

Department of Orthopedics and Rehabilitation, University of Wisconsin Hospital and Clinic, Madison, Wisconsin, USA.

出版信息

Arthroscopy. 2007 Sep;23(9):923-9. doi: 10.1016/j.arthro.2007.04.005.

Abstract

PURPOSE

The purpose of this study was to determine the depth of penetration from mechanical chondroplasty and metabolic consequences of this procedure on the remaining articular cartilage.

METHODS

Mechanical chondroplasty was performed in vitro on a portion of fresh grade I or II articular cartilage from 8 human knee arthroplasty specimens. Treated and control (untreated) explants (approximately 30 mg) were cut from the cartilage. The explants were divided into 2 groups, day 1 and day 4, placed separately in a 48-well plate containing media, and incubated at 37 degrees C for 24 hours. After the 24-hour incubation, the explants were weighed on day 1 and day 4, and explant media were removed and tested for total proteoglycan synthesis and aggrecan synthesis. At time 0, 2 sets (2.6 mm each) of treated and control cartilage slices were cut with a precision saw. One set was stained for confocal laser microscopy via a cytotoxicity stain to determine cell viability. The second set was stained with H&E to determine depth of penetration.

RESULTS

The mean depth of penetration was 252.8 +/- 78 microm. There was no significant difference (P > .25) between total proteoglycan synthesis for control versus treatment groups on day 1 or 4. Aggrecan synthesis was significantly reduced on day 1 when normalized for tissue weight (P = .019) and double-stranded deoxyribonucleic acid (P = .004). On day 4, no significant difference was detected. Confocal laser microscopy did not show cell death below the zone of treatment.

CONCLUSIONS

There was no significant metabolic consequence caused by chondroplasty to the remaining articular cartilage, and the zone of injury was limited to the treatment area.

CLINICAL RELEVANCE

Mechanical chondroplasty causes no significant metabolic consequences to articular cartilage under these conditions.

摘要

目的

本研究旨在确定机械性软骨成形术的穿透深度以及该手术对剩余关节软骨的代谢影响。

方法

对8例人类膝关节置换标本的部分新鲜I级或II级关节软骨进行体外机械性软骨成形术。从软骨上切取经处理和对照(未处理)的外植体(约30毫克)。将外植体分为两组,第1天组和第4天组,分别置于含有培养基的48孔板中,在37℃孵育24小时。孵育24小时后,在第1天和第4天对外植体称重,并去除外植体培养基,检测总蛋白聚糖合成和聚集蛋白聚糖合成。在时间0时,用精密锯切取两组(每组2.6毫米)经处理和对照的软骨切片。一组通过细胞毒性染色进行共聚焦激光显微镜检查以确定细胞活力。第二组用苏木精和伊红染色以确定穿透深度。

结果

平均穿透深度为252.8±78微米。第1天或第4天,对照组与处理组的总蛋白聚糖合成之间无显著差异(P>.25)。当以组织重量(P=.019)和双链脱氧核糖核酸(P=.004)进行标准化时,第1天聚集蛋白聚糖合成显著降低。在第4天,未检测到显著差异。共聚焦激光显微镜检查未显示治疗区域以下的细胞死亡。

结论

软骨成形术对剩余关节软骨未造成显著的代谢影响,损伤区域仅限于治疗区域。

临床意义

在这些条件下,机械性软骨成形术对关节软骨未造成显著的代谢影响。

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