Matsuo Tomohiko, Kita Keisuke, Mae Tatsuo, Yonetani Yasukazu, Miyamoto Satoshi, Yoshikawa Hideki, Nakata Ken
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.
Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 583-8555, Japan.
Knee Surg Sports Traumatol Arthrosc. 2015 May;23(5):1401-1409. doi: 10.1007/s00167-014-2853-4. Epub 2014 Feb 1.
The purpose of this study was to identify the optimal material and implantation method for subchondral bone repair.
Four osteochondral defects in a femoral groove were created in both knees of 12 pigs, and the total number of defects was 96. Eight defects were left empty (empty group). Beta-tricalcium phosphate (β-TCP) bone substitutes with 75 and 67 % porosity were implanted in 30 and 29 defects, respectively (β-TCP75 and β-TCP67 groups). Hydroxyapatite (HA) bone substitutes with 75 % porosity were filled in 29 defects (HA group). Bone substitutes were implanted at 0, 2, or 4 mm below the subchondral bone plate (SBP). The reparative tissue was assessed using microfocus computed tomography and histology 3 months after implantation.
Regardless of the kind of bone substitutes, the defects were filled almost completely after implanting them at the level of the SBP, while the defects remained after implanting them at 2 or 4 mm below the SBP. Reparative tissue of the β-TCP75 group was similar to the normal cancellous bone, while that of the β-TCP67 or HA group was not.
Subchondral bone defects were filled almost completely only when bone substitutes were implanted at the level of the SBP. The reparative tissue after implanting the β-TCP bone substitutes with 75 % porosity was the most similar to the normal cancellous bone. Therefore, implanting the β-TCP bone substitutes with 75 % porosity at the level of the SBP could be recommended as a treatment method for subchondral bone repair in osteochondral defects.
I.
本研究旨在确定用于软骨下骨修复的最佳材料及植入方法。
在12头猪的双膝关节股骨沟处制造4个骨软骨缺损，缺损总数为96个。8个缺损留空作为空白组。孔隙率分别为75%和67%的β-磷酸三钙（β-TCP）骨替代物分别植入30个和29个缺损处（β-TCP75组和β-TCP67组）。孔隙率为75%的羟基磷灰石（HA）骨替代物填充于29个缺损处（HA组）。骨替代物植入软骨下骨板（SBP）下方0、2或4毫米处。植入3个月后，使用微焦点计算机断层扫描和组织学评估修复组织。
无论骨替代物种类如何，在SBP水平植入后缺损几乎完全被填充，而在SBP下方2或4毫米处植入后缺损仍存在。β-TCP75组的修复组织与正常松质骨相似，而β-TCP67组或HA组的则不然。
只有在SBP水平植入骨替代物时，软骨下骨缺损才能几乎完全被填充。植入孔隙率为75%的β-TCP骨替代物后的修复组织与正常松质骨最为相似。因此，推荐在SBP水平植入孔隙率为75%的β-TCP骨替代物作为骨软骨缺损中软骨下骨修复的治疗方法。
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