Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, Hertfordshire, AL9 7TA, United Kingdom.
Writtle Agricultural College, Lordship Road, Chelmsford, Essex, CM1 3RR, United Kingdom.
J Orthop Res. 2020 Jan;38(1):128-138. doi: 10.1002/jor.24423. Epub 2019 Aug 16.
Intra-synovial tendon injuries are a common orthopedic problem with limited treatment options. The synovium is a specialized connective tissue forming the inner encapsulating lining of diarthrodial joints and intra-synovial tendons. It contains multipotent mesenchymal stromal cells that render it a viable source of progenitors for tendon repair. This study evaluated the effects of autologous implantation of cells derived from normal synovium (synovial membrane cells [SMCs]) in augmenting repair in an ovine model of intra-synovial tendon injury. For this purpose, synovial biopsies were taken from the right digital flexor tendon sheath following creation of a defect to the lateral deep digital flexor tendon. Mononuclear cells were isolated by partial enzymatic digestion and assessed for MSC characteristics. Cell tracking and tendon repair were assessed by implanting 5 × 10 cells into the digital flexor tendon sheath under ultrasound guidance with the effects evaluated using magnetic resonance imaging and histopathology. Synovial biopsies yielded an average 4.0 × 10 ± 2.7 × 10 SMCs that exhibited a fibroblastic morphology, variable osteogenic, and adipogenic responses but were ubiquitously strongly chondrogenic. SMCs displayed high expression of CD29 with CD271 and MHC-II cell-surface marker profiles, and variable expression of CD73, CD90, CD105, CD166, and MHC-I. Implanted SMCs demonstrated engraftment within the synovium, though a lack of repair of the tendon lesion over 24 weeks was observed. We conclude healthy synovium is a viable source of multipotent cells, but that the heterogeneity of synovium underlies the variability between different SMC populations, which while capable of engraftment and persistence within the synovium exhibit limited capacity of influencing tendon repair. © 2019 The Authors. Journal of Orthopaedic Research published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society J Orthop Res 38:128-138, 2020.
关节内肌腱损伤是一种常见的骨科问题，治疗选择有限。滑膜是一种特殊的结缔组织，形成关节的内包裹层和关节内肌腱。它含有多能间充质基质细胞，使其成为肌腱修复的可行祖细胞来源。本研究评估了自体植入正常滑膜（滑膜膜细胞[SMCs]）衍生细胞对羊模型关节内肌腱损伤修复的增强作用。为此，在外侧深屈肌腱损伤后，从右指屈肌腱鞘中取出滑膜活检。通过部分酶消化分离单核细胞，并评估其 MSC 特征。通过超声引导将 5×10 个细胞植入指屈肌腱鞘中进行细胞追踪和肌腱修复，通过磁共振成像和组织病理学评估效果。滑膜活检平均获得 4.0×10±2.7×10 SMC，呈纤维母细胞形态，具有可变的成骨和成脂反应，但普遍强烈的成软骨反应。SMC 表达高水平的 CD29，具有 CD271 和 MHC-II 细胞表面标志物特征，CD73、CD90、CD105、CD166 和 MHC-I 的表达可变。植入的 SMC 在内滑膜中表现出植入，但在 24 周内未观察到肌腱病变的修复。我们得出结论，健康的滑膜是多能细胞的可行来源，但滑膜的异质性是不同 SMC 群体之间变异性的基础，尽管能够植入和在滑膜中持续存在，但它们影响肌腱修复的能力有限。
