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验证密苏里关节软骨同种异体移植保存系统在长时间存储过程中维持关节软骨同种异体移植物质量的能力。

Validation of the Missouri Osteochondral Allograft Preservation System for the Maintenance of Osteochondral Allograft Quality During Prolonged Storage.

机构信息

Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, USA.

Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri, USA.

出版信息

Am J Sports Med. 2018 Jan;46(1):58-65. doi: 10.1177/0363546517727516. Epub 2017 Sep 22.

Abstract

BACKGROUND

Fresh osteochondral allografts (OCAs) are limited in availability. The Missouri Osteochondral Allograft Preservation System (MOPS) has been reported to effectively preserve OCAs twice as long as current tissue bank protocols in preclinical studies.

HYPOTHESIS

The viable chondrocyte density (VCD) in OCAs preserved for up to 70 days using the MOPS will not be significantly different from day 0, and the VCD in MOPS-preserved OCAs will be significantly higher than for standard tissue bank preservation. Media changes during preservation will significantly improve the VCD.

STUDY DESIGN

Controlled laboratory study.

METHODS

Femoral condyles harvested from qualified donors (n = 12) were quartered (n = 48), assigned to 1 of 4 treatment groups (tissue bank protocol at 4°C or MOPS at 25°C, with or without media changes), and preserved for 0, 28, 56, or 70 days and assessed for the VCD and histopathological characteristics. In addition, osteochondral explants were created from the femoral condyles of 12 donors (n = 36 explants), assigned to the same groups and time points, and tested for biomechanical properties.

RESULTS

MOPS-preserved OCAs maintained the day 0 VCD through 56 days. OCAs stored using current tissue bank protocols had a significantly lower VCD compared with day 0 and the MOPS by day 28. OCA histological and biomechanical properties did not significantly change from day 0 for any group.

CONCLUSION

The MOPS preserved essential OCA viability and quality at significantly higher levels than current tissue bank protocols for at least 56 days after procurement.

CLINICAL RELEVANCE

Improving the viability and duration of OCA preservation provides potential benefits to tissue banks, donor families, surgeons, and patients with respect to tissue use, financial costs, and outcomes.

摘要

背景

新鲜的异体骨软骨移植物(OCAs)供应有限。密苏里州骨软骨同种异体移植物保存系统(MOPS)已被报道在临床前研究中能将 OCAs 的保存时间延长一倍,超过当前组织库的保存方案。

假设

使用 MOPS 保存最长 70 天的 OCAs 的活软骨细胞密度(VCD)与第 0 天相比没有显著差异,并且 MOPS 保存的 OCAs 的 VCD 显著高于标准组织库保存的 OCAs。保存过程中的介质更换将显著提高 VCD。

研究设计

对照实验室研究。

方法

从合格供体中采集股骨髁(n = 12),将其四等分(n = 48),分配到 4 个处理组中的 1 个(4°C 的组织库方案或 25°C 的 MOPS,有或没有介质更换),并分别保存 0、28、56 或 70 天,评估 VCD 和组织病理学特征。此外,从 12 名供体的股骨髁中创建骨软骨解剖标本(n = 36 个解剖标本),分配到相同的组和时间点,并进行生物力学测试。

结果

MOPS 保存的 OCAs 在 56 天内保持第 0 天的 VCD。使用当前组织库方案保存的 OCAs 在第 28 天的 VCD 显著低于第 0 天和 MOPS。在任何组中,OCAs 的组织学和生物力学特性与第 0 天相比均无显著变化。

结论

MOPS 保存的 OCAs 保持了显著高于当前组织库方案的活度和质量,至少在采集后 56 天内保持稳定。

临床相关性

提高 OCAs 的保存活力和时间可使组织库、供体家庭、外科医生和接受组织移植的患者在组织利用、经济成本和结果方面受益。

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