Department of Orthopaedics and Traumatology, University of Torino, Torino, Italy.
Knee Surg Sports Traumatol Arthrosc. 2012 Dec;20(12):2590-601. doi: 10.1007/s00167-012-1920-y. Epub 2012 Feb 21.
This study proposes a single-step therapeutic approach for osteochondral defects using autologous cartilage fragments loaded onto a scaffold composed of a hyaluronic acid (HA) derivative, human fibrin glue (FG) and autologous platelet-rich-plasma (PRP), in a rabbit model. The aim is to demonstrate the in vitro outgrowth of chondrocytes from cartilage fragments and the in vivo formation of a functional repair tissue.
In vitro: minced articular cartilage was loaded onto two different types of scaffold (paste or membrane) according to two different HA preparations (injectable HA-derivative or HA-derivative felt). In vivo: trochlear osteochondral defects were created in 50 adult rabbits, which were then assigned to 5 different treatment groups: cartilage fragments loaded onto membrane scaffolds with FG (Group 1) or without FG (Group 2); membrane scaffolds alone with FG (Group 3) or without FG (Group 4); empty defects (Group 5). Membrane scaffolds were used "in vivo" for simpler preparation and better adhesive properties. Repair processes were evaluated histologically and by immunohistochemistry at 1, 3, and 6 months.
An in vitro time-dependent cell outgrowth from cartilage fragments was observed with both types of scaffolds. At 6 months, in vivo, cartilage fragment-loaded scaffolds induced significantly better repair tissue than the scaffold alone using histological scoring. Repair in Group 2 was superior to that in any of the control groups (p < 0.05).
Autologous cartilage fragments loaded onto an HA felt/FG/PRP-scaffold provided an efficient cell source, and allowed for an improvement of the repair process of ostechondral defects in a rabbit model. Human FG, however, hampered the rabbit healing process. These results may have clinical relevance as they show the potential of a novel one-stage repair technique for osteochondral defects.
本研究提出了一种使用自体软骨碎片加载到由透明质酸（HA）衍生物、人纤维蛋白胶（FG）和自体富血小板血浆（PRP）组成的支架上的单一治疗方法，用于兔模型中的骨软骨缺损。目的是证明软骨碎片的软骨细胞在体外生长和体内功能性修复组织的形成。
体外：将关节软骨切成小块，根据两种不同的 HA 制剂（可注射的 HA 衍生物或 HA 衍生物毡）加载到两种不同类型的支架（糊剂或膜）上。体内：在 50 只成年兔的滑车骨软骨缺损中创建，然后将其分为 5 个不同的治疗组：用 FG 加载到膜支架上的软骨碎片（第 1 组）或无 FG（第 2 组）；用 FG 加载到膜支架上的膜支架（第 3 组）或无 FG（第 4 组）；空缺陷（第 5 组）。膜支架用于“体内”，以便于制备和更好的粘附性能。在 1、3 和 6 个月时，通过组织学和免疫组织化学评估修复过程。
在两种类型的支架上均观察到软骨碎片的体外时间依赖性细胞生长。在 6 个月时，体内，与单独使用支架相比，负载软骨碎片的支架明显更好地诱导修复组织，使用组织学评分进行评估。与任何对照组相比，第 2 组的修复均优于其他对照组（p <0.05）。
自体软骨碎片加载到 HA 毡/FG/PRP 支架上为骨软骨缺损的修复提供了有效的细胞来源，并改善了兔模型中的修复过程。然而，人 FG 阻碍了兔的愈合过程。这些结果可能具有临床相关性，因为它们显示了一种新型的骨软骨缺损一期修复技术的潜力。
