Chan Elaine F, Liu I-Ling, Semler Eric J, Aberman Harold M, Simon Timothy M, Chen Albert C, Truncale Kate G, Sah Robert L
Department of Bioengineering, University of California, San Diego.
Cartilage. 2012 Jul 1;3(3):255-66. doi: 10.1177/1947603511435272.
The articular cartilage of autologous osteochondral grafts is typically different in structure and function from local host cartilage and thereby presents a remodeling challenge. The hypothesis of this study was that properties of the articular cartilage of trochlear autografts and adjacent femoral condyle are associated with the 3-D geometrical match between grafted and contralateral joints at 6 and 12 months after surgery.
Autografts were transferred unilaterally from the lateral trochlea (LT) to the medial femoral condyle (MFC) in adult Spanish goats. Operated and contralateral Non-Operated joints were harvested at 6 and 12 months, and analyzed by indentation testing, micro-computed tomography, and histology to compare (1) histological indices of repair, (2) 3-D structure (articular surface deviation, bone-cartilage interface deviation, cartilage thickness), (3) indentation stiffness, and (4) correlations between stiffness and 3-D structure.
Cartilage deterioration was present in grafts at 6 months and more severe at 12 months. Cartilage thickness and normalized stiffness of Operated MFC were lower than Non-Operated MFC within the graft and proximal adjacent host regions. Operated MFC articular surfaces were recessed relative to Non-Operated MFC and exhibited lower cartilage stiffness with increasing recession. Sites with large bone-cartilage interface deviations, both proud and recessed, were associated with recessed articular surfaces and low cartilage stiffness.
The effectiveness of cartilage repair by osteochondral grafting is associated with the match of 3-D cartilage and bone geometry to the native osteochondral structure.
自体骨软骨移植的关节软骨在结构和功能上通常与局部宿主软骨不同,因此带来了重塑挑战。本研究的假设是,滑车自体移植和相邻股骨髁的关节软骨特性与术后6个月和12个月移植关节和对侧关节之间的三维几何匹配有关。
在成年西班牙山羊中,将自体移植物从外侧滑车(LT)单侧转移至内侧股骨髁(MFC)。在6个月和12个月时采集手术侧和对侧未手术关节,通过压痕测试、微型计算机断层扫描和组织学分析,以比较(1)修复的组织学指标,(2)三维结构(关节面偏差、骨软骨界面偏差、软骨厚度),(3)压痕硬度,以及(4)硬度与三维结构之间的相关性。
移植软骨在6个月时出现退变,在12个月时更严重。在移植物和近端相邻宿主区域内,手术侧MFC的软骨厚度和标准化硬度低于未手术侧MFC。手术侧MFC关节面相对于未手术侧MFC凹陷,且随着凹陷增加软骨硬度降低。骨软骨界面偏差较大的部位,无论是凸起还是凹陷,都与关节面凹陷和软骨硬度低有关。
骨软骨移植修复软骨的有效性与软骨和骨的三维几何结构与天然骨软骨结构的匹配有关。