Akman Yunus Emre, Sukur Erhan, Senel Ahmet, Oztas Sukur Nur Ece, Talu Canan Kelten, Ozturkmen Yusuf
Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
University of Sakarya, Sakarya Training and Research Hospital, Department of Orthopaedics and Traumatology, Sakarya, Turkey.
Acta Orthop Traumatol Turc. 2017 Jul;51(4):331-336. doi: 10.1016/j.aott.2017.04.001. Epub 2017 Jun 13.
The aim of this experimental study was to investigate the impact of HA-CS-NAG compound (hyaluronate, sodium chondroitin sulfate, N-acetyl-d-glucosamine) on the quality of repair tissue after micro-fracture and to compare it with HA (hyaluronat), in a rat full-thickness chondral defect model.
Full-thickness chondral defects were created in a non-weight bearing area by using a handle 2.7-mm drill bit, in the right knees of 33 Sprague-Dawley rats. Each specimen then underwent micro-fracture using a needle. Two weeks after surgery, 3 groups were randomly formed among the rats (n = 33). In Group 1, 0.2 mL of sterile saline solution (0.9%) was injected. In Group 2, 0.2 mL HA with a mean molecular weight of 1.2 Mda was injected. In Group 3, 0.2 mL of HA-CS-NAG compound (hyaluronate, sodium chondroitin sulfate, N-acetyl-d-glucosamine) was injected. The injections were applied on the 14th, the 21st and the 28th postoperative days. All rats were sacrificed on the 42nd postoperative day. Histological analysis of the repair tissue was performed for each specimen by two blinded observers using Wakitani scoring system.
There was significantly improved repair tissue in both Group 3 and Group 2 when compared with Group 1. Group 3 showed statistically significant improvement in terms of 'cell morphology' and 'integration of donor with host' when compared to Group 2 (p < 0.001).
Intra-articular injection of HA-CS-NAG compound after micro-fracture results in significantly improved repair tissue in rats' chondral defects when compared to HA regarding the donor integration and cell morphology.
本实验研究旨在探讨透明质酸-硫酸软骨素-N-乙酰-D-葡萄糖胺复合物(HA-CS-NAG,即透明质酸盐、硫酸软骨素钠、N-乙酰-D-葡萄糖胺)对大鼠全层软骨缺损微骨折术后修复组织质量的影响,并在大鼠全层软骨缺损模型中将其与透明质酸(HA)进行比较。
使用2.7毫米的手持钻头在33只Sprague-Dawley大鼠右膝的非负重区域制造全层软骨缺损。然后用针对每个标本进行微骨折处理。术后两周,将大鼠随机分为3组(n = 33)。第1组注射0.2毫升无菌盐溶液(0.9%)。第2组注射0.2毫升平均分子量为1.2兆道尔顿的HA。第3组注射0.2毫升HA-CS-NAG复合物(透明质酸盐、硫酸软骨素钠、N-乙酰-D-葡萄糖胺)。分别在术后第14天、第21天和第28天进行注射。所有大鼠在术后第42天处死。由两名盲法观察者使用Wakitani评分系统对每个标本的修复组织进行组织学分析。
与第1组相比,第3组和第2组的修复组织均有显著改善。与第2组相比,第3组在“细胞形态”和“供体与宿主的整合”方面有统计学意义上的显著改善(p < 0.001)。
与HA相比,微骨折术后关节内注射HA-CS-NAG复合物在供体整合和细胞形态方面能使大鼠软骨缺损的修复组织得到显著改善。