Baumbach Klaus, Petersen Jan-Philipp, Ueblacker Peter, Schröder Jens, Göpfert Christiane, Stork Alexander, Rueger Johannes M, Amling Michael, Meenen Norbert M
Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Arch Orthop Trauma Surg. 2008 Nov;128(11):1255-63. doi: 10.1007/s00402-007-0532-3. Epub 2007 Dec 6.
Because articular cartilage shows little intrinsic capacity of spontaneous regeneration, a variety of treatment options are currently at use to repair cartilage damage. One of these is the autologous osteochondral transplantation (AOT). The aim of the present work was to study the histological changes during the progress of 1 year after AOT in the knee joint.
Twelve Minipigs underwent an AOT on the medial femoral condyles of both knees using cooled diamond studded trephines with a diameter of the grafts of 4.6 mm. Three animals were sacrificed at each 2, 8, 26 and 52 weeks after the operation. The condyles were analyzed histologically and immunohistologically for collagen types I and II.
A successful bony incorporation was observed in all specimens. The transplant demonstrated an increasingly stable integration of the chondral matrix into the cartilage of the surrounding femoral condyle. At 52 weeks after the operations 5 of 6 condyles showed a chondral integration at least at one side of the graft. Immunohistologically all specimens showed physiological staining characteristics up to 52 weeks after operation. The quality of the chondral part of the graft showed a wide range of variations, ranging from vital tissue resembling native cartilage after 52 weeks, to severe degenerative signs beginning 2 weeks after operation and ending at 52 weeks with deep fissures fragmenting the cartilage and the complete loss of vital cells.
The press-fit technique allows a stable bony incorporation. A chondral integration of the graft seems to occur, provided that a close contact between the interfaces can be achieved. Present results demonstrate a vital cartilagenous transplant for up to 52 weeks. However, some specimens showed in part severe degenerative signs. A possible explanation is an insufficient cooling of the trephines in relation to the small diameter of the grafts used in the minipig model. The collagen network seems not to be affected for up to 52 weeks.
由于关节软骨的自发再生能力较弱,目前有多种治疗方法用于修复软骨损伤。其中之一是自体骨软骨移植(AOT)。本研究的目的是观察膝关节AOT术后1年的组织学变化。
12只小型猪双侧膝关节内侧股骨髁采用直径4.6mm的带冷却装置的金刚石环钻进行AOT。术后2、8、26和52周分别处死3只动物。对股骨髁进行组织学和免疫组织学分析,检测I型和II型胶原。
所有标本均观察到成功的骨结合。移植组织显示软骨基质与周围股骨髁软骨的整合越来越稳定。术后52周,6个髁中有5个至少在移植组织的一侧显示软骨整合。免疫组织学分析显示,所有标本在术后52周内均呈现生理染色特征。移植组织软骨部分的质量差异很大,从术后52周时类似天然软骨的活性组织,到术后2周开始出现的严重退变迹象,至52周时软骨出现深裂隙、细胞完全丧失。
压配技术可实现稳定的骨结合。如果移植组织与周围组织界面能紧密接触,似乎可发生软骨整合。目前结果表明,移植的软骨在长达52周内保持活性。然而,部分标本出现了严重的退变迹象。一个可能的原因是,在小型猪模型中,相对于所使用的移植组织小直径,环钻冷却不足。在长达52周内,胶原网络似乎未受影响。