Oda Shuhei, Otsuki Shuhei, Kurokawa Yoshitaka, Hoshiyama Yoshiaki, Nakajima Mikio, Neo Masashi
Department of Orthopedic Surgery, Osaka Medical College, Japan.
Department of Orthopedic Surgery, Osaka Medical College, Japan
J Biomater Appl. 2015 May;29(10):1439-48. doi: 10.1177/0885328215568984. Epub 2015 Jan 28.
The aim of this study was to investigate a new method for meniscal repair by combinative transplantation with type I collagen scaffold and infrapatellar fat pad.
Two-mm cylindrical defects at the anterior part of bilateral medial menisci were prepared in nine Japanese white rabbits. The 18 knees were equally divided into three groups: I, no treatment; II, collagen scaffold transplantation; and III, collagen scaffold and infrapatellar fat pad transplantation. Another three rabbits (six knees) underwent sham surgery and served as controls. Rabbits were sacrificed at eight weeks after transplantation. Surface area of the medial meniscus was evaluated using macrophotographs. Ishida score for meniscal regeneration was used for assessment. To evaluate the composition of regenerated tissue, immunohistochemistry was analyzed with anti-type I and anti-type II collagen antibodies, and anti-Ki67 antibody. To investigate the effects of collagen scaffold on human meniscus, cells were isolated from human meniscus and infrapatellar fat pad, and cultured with collagen scaffold for three weeks. After that, gene expression was evaluated by using quantitative real-time polymerase chain reaction.
In group I, the meniscus shrank anterior to posterior, and the surface area was significantly less than that of normal meniscus. However, the surface area was maintained in group III. Ishida score and Ki67-positive cell ratio in group III were significantly higher than that in any other group, and staining with type I and type II collagen was similar to that of the control. Expression of matrix metalloproteinase was significantly lower in cocultures of collagen scaffold, meniscus cell, and infrapatellar fat pad cell than in monocultured meniscus cell, and expression of interleukin-1β was not increased.
This new method for meniscal repair by combinative transplantation with type I collagen scaffold and infrapatellar fat pad showed meniscal regeneration and potential for suppressing inflammation.
本研究旨在探讨一种通过I型胶原支架与髌下脂肪垫联合移植进行半月板修复的新方法。
在9只日本白兔双侧内侧半月板前部制备2毫米的圆柱形缺损。18个膝关节平均分为三组：I组，不治疗；II组，胶原支架移植；III组，胶原支架与髌下脂肪垫移植。另外3只兔子（6个膝关节）接受假手术作为对照。移植后8周处死兔子。使用宏观照片评估内侧半月板的表面积。采用半月板再生的石田评分进行评估。为评估再生组织的组成，用抗I型和抗II型胶原抗体以及抗Ki67抗体进行免疫组织化学分析。为研究胶原支架对人半月板的影响，从人半月板和髌下脂肪垫分离细胞，与胶原支架共培养3周。之后，通过定量实时聚合酶链反应评估基因表达。
I组中，半月板从前向后萎缩，表面积明显小于正常半月板。然而，III组的表面积得以维持。III组的石田评分和Ki67阳性细胞比例显著高于其他任何组，I型和II型胶原染色与对照组相似。胶原支架、半月板细胞和髌下脂肪垫细胞共培养中基质金属蛋白酶的表达明显低于半月板细胞单培养，白细胞介素-1β的表达未增加。
这种通过I型胶原支架与髌下脂肪垫联合移植进行半月板修复的新方法显示出半月板再生及抑制炎症的潜力。
