Vachon A M, McIlwraith C W, Trotter G W, Norrdin R W, Powers B E
Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins 80523.
Am J Vet Res. 1991 Feb;52(2):317-27.
The use of periosteal autografts to resurface osteochondral defects was investigated in 10 horses (2 to 3 years old), and the repair tissue was characterized morphologically. Middle carpal joint arthrotomies were made, and osteochondral defects were induced bilaterally on the distal articular surface of each radial carpal bone. Each defect measured approximately 1 cm2 and extended 3 mm into the subchondral bone plate. Residual subchondral bone plate of control and principal defects was perforated by drilling. A sterile fibrin adhesive was made by mixing a fibrinogen component and a thrombin component. A periosteal autograft was harvested from the proximal portion of the tibia and was glued onto the recipient osseous surface, with its cambium facing the joint cavity. Control defects were glued, but not grafted. Horses were walked 1 hour daily on a walker, starting at postoperative week 7 and continuing for 9 weeks. Sixteen weeks after the grafting procedure was done, carpal radiography was performed, after which horses were euthanatized. Quality of repair tissue of control and grafted defects was evaluated and compared grossly, histologically, and histochemically. Using a reticule, the proportions of various repair tissue types filling each defect were quantitated. Seven weeks after the grafting procedure was done, bilateral arthroscopy revealed synovial adhesions and marginal pannus formation in control and grafted defects. None of the autografts was found floating unattached within the respective middle carpal joints. At 16 weeks, the gross appearance of most grafted and nongrafted defects was similar, and repair was dominated by a fibrous pannus. In 4 grafted defects, bone had formed either concentrically within the defect or eccentrically in the fibrous adhesions between the defect and the joint margin. Histologically, all grafted and nongrafted defects were repaired similarly by infiltration of a mixture of fibrous tissue, fibrocartilage, and bone. Fibrous tissue was the predominant tissue in most defects and its mean proportion was 56 and 59% in the grafted and nongrafted defects, respectively. Fibrocartilaginous tissue in the deeper layers approximated 20%, and woven bone at the base of the defect was 20% in all defects. Histochemically, difference in staining for proteoglycans was not observed between grafted and nongrafted defects. Little remaining original periosteal graft tissue was evident at the defect sites. The only distinguishing feature of grafted defects was the presence of islands of bone formation either at the defect site (n = 2 horses), or in somewhat dorsally displaced tissue that was incorporated in fibrous adhesions (n = 2 horses).(ABSTRACT TRUNCATED AT 400 WORDS)
研究人员对10匹2至3岁的马进行了自体骨膜移植修复骨软骨缺损的实验，并对修复组织进行了形态学特征分析。切开腕中关节，在每块桡腕骨远端关节面双侧制造骨软骨缺损。每个缺损面积约1平方厘米，深入软骨下骨板3毫米。对对照缺损和主要缺损的残留软骨下骨板进行钻孔。将纤维蛋白原成分和凝血酶成分混合制成无菌纤维蛋白粘合剂。从胫骨近端获取自体骨膜，将其贴在受体骨表面，其形成层朝向关节腔。对照缺损仅用粘合剂粘贴，未进行移植。从术后第7周开始，让马每天在步行器上行走1小时，持续9周。移植手术后16周，进行腕关节X线摄影，之后对马实施安乐死。对对照缺损和移植缺损的修复组织质量进行大体、组织学和组织化学评估及比较。使用网格对填充每个缺损的各种修复组织类型的比例进行定量分析。移植手术后7周，双侧关节镜检查显示对照缺损和移植缺损均有滑膜粘连和边缘血管翳形成。未发现自体骨膜移植片在各自的腕中关节内游离。16周时，大多数移植缺损和未移植缺损的大体外观相似，修复主要由纤维血管翳主导。在4个移植缺损中，骨在缺损内同心形成或在缺损与关节边缘之间的纤维粘连中偏心形成。组织学上，所有移植缺损和未移植缺损的修复情况相似，均有纤维组织、纤维软骨和骨的混合物浸润。纤维组织是大多数缺损中的主要组织，在移植缺损和未移植缺损中的平均比例分别为56%和59%。较深层的纤维软骨组织约占20%，缺损底部的编织骨在所有缺损中均占20%。组织化学上，移植缺损和未移植缺损之间未观察到蛋白聚糖染色差异。在缺损部位几乎看不到残留的原始骨膜移植组织。移植缺损的唯一显著特征是在缺损部位（2匹马）或在融入纤维粘连的稍向背侧移位的组织中（2匹马）存在骨形成岛。（摘要截选至400字）
