Department of Orthopaedics, Hospital Obispo Polanco, Teruel, Spain.
Arthroscopy. 2010 Jan;26(1):76-83. doi: 10.1016/j.arthro.2009.07.005.
To evaluate the repaired tissues formed in full-thickness cartilage defects in a rabbit model implanted with autogenous periosteal grafts under the influence of continuous passive motion (CPM) establishing a correlation between histology, histomorphometry, and mechanical behavior.
Autogenous periosteal grafts were used to resurface full-thickness defects produced in the trochlear groove in the right knees of 60 New Zealand rabbits. Four groups were formed according to the time to death and postoperative mobilization: group A--active intermittent motion, euthanized at 8 weeks; group B--CPM, euthanized at 8 weeks; group C--active intermittent motion, euthanized at 36 weeks; and group D, CPM, euthanized at 36 weeks. Repaired tissues were evaluated grossly, histologically, and mechanically, as well as by histomorphometry.
The repair tissue was hyaline-like cartilage in 68.1% of the specimens in group A, 71.4% in group B, 0% in group C, and 20% in group D. The mean thickness of the regenerated tissue was 1.20 mm in group A, 1.23 mm in group B, 0.20 mm in group C, and 0.25 in group D. Elastic stiffness at 8 weeks was lower than that of the control cartilage and increased significantly at 36 weeks because of degenerative changes. Postoperative motion showed no influence on the results. Repaired tissue developed severe degenerative changes in time, and deterioration of the mechanical properties was observed without any protective effect of the CPM.
Full-thickness cartilage defects treated with autologous periosteal grafts were repaired with hyaline-like cartilage tissue. Regenerated tissue showed viscoelastic behavior similar to normal cartilage 8 weeks after surgery. CPM did not improve histologic or mechanical results. Repaired tissue did not last over time.
Free periosteal grafts should not be used clinically in the treatment of full-thickness cartilage defects because even though regenerated tissue seems initially to be hyaline-like cartilage, it is not capable of maintaining its histologic and mechanical properties over a long period of time.
评估兔模型中自体骨膜移植物在持续被动运动（CPM）影响下全层软骨缺损形成的修复组织，将组织学、组织形态计量学和力学行为联系起来。
使用自体骨膜移植物覆盖右膝关节滑车沟产生的全层缺陷。根据死亡时间和术后活动分为 4 组：A 组-主动间歇运动，8 周处死；B 组-CPM，8 周处死；C 组-主动间歇运动，36 周处死；D 组，CPM，36 周处死。大体、组织学、力学和组织形态计量学评估修复组织。
A 组 68.1%、B 组 71.4%、C 组 0%、D 组 20%的标本修复组织为透明软骨样。A 组再生组织平均厚度为 1.20mm，B 组为 1.23mm，C 组为 0.20mm，D 组为 0.25mm。8 周时弹性刚度低于对照软骨，36 周时因退行性变化显著增加。术后运动对结果无影响。修复组织随时间发生严重退行性变化，机械性能恶化，CPM 无保护作用。
自体骨膜移植治疗全层软骨缺损可修复透明软骨样组织。术后 8 周再生组织表现出与正常软骨相似的粘弹性行为。CPM 并未改善组织学或力学结果。修复组织不会随时间延长而持续。
游离骨膜移植物不应在全层软骨缺损的临床治疗中使用，因为即使再生组织最初似乎是透明软骨样，但它不能在很长一段时间内保持其组织学和机械性能。
