Bonasia Davide Edoardo, Martin James A, Marmotti Antonio, Kurriger Gail L, Lehman Abigail D, Rossi Roberto, Amendola Annunziato
1st Department of Orthopaedics and Traumatology, University of Torino, Via Lamarmora 26, 10128, Turin, Italy.
University of Iowa, Iowa City, IA, USA.
Knee Surg Sports Traumatol Arthrosc. 2016 Dec;24(12):3988-3996. doi: 10.1007/s00167-015-3536-5. Epub 2015 Feb 10.
The goal of the study was to evaluate the repair of chondral lesions treated with combined autologous adult/allogenic juvenile cartilage fragments, compared with isolated adult and isolated juvenile cartilage fragments.
Fifty-eight adult (>16 week old) and five juvenile (<6 week old) New Zealand White female rabbits were used. A large osteochondral defect was created in the center of the femoral trochlea of adult rabbits. The rabbits were divided in four groups: Group 1 = untreated defects (controls); Group 2 = adult cartilage fragments; Group 3 = juvenile cartilage fragments; and Group 4 = adult + juvenile cartilage fragments. Killings were performed at 3 and 6 months. The defects were evaluated with ICRS macroscopic score, modified O'Driscoll score, and Collagen type II immunostaining.
At 3 months, Group 4 performed better than Group 1, in terms of modified O'Driscoll score (p = 0.001) and Collagen type II immunostaining (p = 0.015). At 6 months, Group 4 showed higher modified O'Driscoll score (p = 0.003) and Collagen type II immunostaining score (p < 0.001) than Group 1. Histologically, also Group 3 performed better than Group 1 (p = 0.03), and Group 4 performed better than Group 2 (p = 0.004).
Mixing adult and juvenile cartilage fragments improved cartilage repair in a rabbit model. In the clinical setting, a new "one-stage" procedure combining the two cartilage sources can be hypothesized, with the advantages of improved chondral repair and large defect coverage, because of the use of an off-the-shelf juvenile allograft. Further studies on larger animals and clinical trials are required to confirm these results.
本研究的目的是评估与单独使用成年自体软骨碎片和单独使用幼年异体软骨碎片相比，联合使用成年自体/异体幼年软骨碎片治疗软骨损伤的修复效果。
使用58只成年（>16周龄）和5只幼年（<6周龄）新西兰白兔雌性。在成年兔股骨滑车中央制造一个大的骨软骨缺损。将兔子分为四组：第1组=未治疗缺损（对照组）；第2组=成年软骨碎片；第3组=幼年软骨碎片；第4组=成年+幼年软骨碎片。在3个月和6个月时进行处死。用国际软骨修复协会（ICRS）宏观评分、改良奥德里斯科尔评分和II型胶原免疫染色对缺损进行评估。
在3个月时，就改良奥德里斯科尔评分（p = 0.001）和II型胶原免疫染色（p = 0.015）而言，第4组的表现优于第1组。在6个月时，第4组的改良奥德里斯科尔评分（p = 0.003）和II型胶原免疫染色评分（p < 0.001）高于第1组。组织学上，第3组的表现也优于第1组（p = 0.03），第4组的表现优于第2组（p = 0.004）。
在兔模型中，混合成年和幼年软骨碎片可改善软骨修复。在临床环境中，可以设想一种新的“一期”手术，将两种软骨来源结合起来，由于使用现成的幼年同种异体移植物，具有改善软骨修复和覆盖大缺损的优点。需要对更大动物进行进一步研究和临床试验来证实这些结果。
