Institute of Biomedical Engineering, National Cheng Kung University, 1 University Rd, Tainan City 701, Taiwan.
Ann Biomed Eng. 2013 Feb;41(2):385-97. doi: 10.1007/s10439-012-0656-7. Epub 2012 Sep 18.
Remedying patellofemoral osteochondral defects using clinical therapy remains challenging. Construct-based and cell-based regenerative medicine with in vitro physical stimuli has been progressively implemented. However, the effect of physical stimuli in situ in knee joints with degradable constructs is still not well-documented. Therefore, we studied whether it was practical to achieve articular cartilage repair using a poly(lactic-co-glycolic acid) (PLGA) construct in addition to early short-term continuous passive motion (CPM) for treatment of full-thickness osteochondral defects in the lower-weigh bearing (LWB) zone of the femoral trocheal groove. Twenty-six rabbits were randomly allocated into either intermittent active motion (IAM) or CPM treatment groups with or without PLGA constructs, termed PLGA construct-implanted (PCI) and empty defect knee models, respectively. Gross observation, histology, inflammatory cells, which were identified using H&E staining, total collagen and alignment, studied qualitatively using Masson's trichrome staining, glycosaminoglycan (GAG), identified using Alcian blue staining, and newly formed bone, observed using micro-CT, were evaluated at 4 and 12 weeks after surgery. Repair of osteochondral defects in the PCI-CPM group was more promising than all other groups. The better osteochondral defect repair in the PCI-CPM group corresponded to smooth cartilage surfaces, no inflammatory reaction, hyaline cartilaginous tissues composition, sound collagen alignment with positive collagen type II expression, higher GAG content, mature bone regeneration with osteocyte, clear tidemark formation, and better degradation of PLGA. In summary, the use of a simple PLGA construct coupled with passive motion promotes positive healing and may be a promising clinical intervention for osteochondral regeneration in LWB defects.
使用临床治疗方法来修复髌股关节骨软骨缺损仍然具有挑战性。基于构建体和基于细胞的再生医学结合体外物理刺激已逐渐得到实施。然而，在可降解构建体的膝关节中，体内物理刺激的效果仍未得到充分记录。因此，我们研究了在股骨滑车沟的低负重区（LWB）使用聚（乳酸-共-乙醇酸）（PLGA）构建体以及早期短期持续被动运动（CPM）治疗全层骨软骨缺损是否可行。26 只兔子随机分配到间歇主动运动（IAM）或 CPM 治疗组，分别带有或不带有 PLGA 构建体，分别称为 PLGA 构建体植入（PCI）和空缺陷膝关节模型。术后 4 和 12 周，通过大体观察、组织学、使用 H&E 染色鉴定的炎症细胞、使用 Masson 三色染色定性研究的总胶原和排列、使用 Alcian 蓝染色鉴定的糖胺聚糖（GAG）以及使用微 CT 观察到的新形成的骨来评估。在 PCI-CPM 组中，骨软骨缺损的修复比其他所有组都更有希望。在 PCI-CPM 组中，更好的骨软骨缺损修复对应于光滑的软骨表面、无炎症反应、透明软骨组织成分、具有阳性 II 型胶原表达的健全胶原排列、更高的 GAG 含量、具有骨细胞的成熟骨再生、清晰的边界形成以及更好的 PLGA 降解。总之，使用简单的 PLGA 构建体结合被动运动可促进积极的愈合，可能是 LWB 缺陷骨软骨再生的一种有前途的临床干预措施。
