Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.
Department of QOL Research Center Laboratory, Gunze Limited, Osaka, Japan.
Cartilage. 2021 Dec;13(2_suppl):1551S-1561S. doi: 10.1177/1947603519870838. Epub 2019 Aug 30.
To investigate meniscal regeneration and prevent cartilage degeneration using wrapping treatment for meniscal horizontal tears that have been difficult to repair in rabbits.
Thirty knees from 15 Japanese white rabbits were divided into the horizontal (horizontal tears) or wrapping (horizontal tears with wrapping treatment) groups. Horizontal tears were created and wrapped with a sheet scaffold containing polyglycolic acid, polylactic acid, and polycaprolactone. The meniscus was stained with Safranin-O/Fast Green and evaluated with modified Pauli scores at 8, 12, and 16 weeks after implantation ( = 5). Cell morphology was determined with hematoxylin and eosin staining. Mature collagen was confirmed with Picrosirius Red staining. Furthermore, immunohistochemical analysis of inducible nitric oxide synthase (iNOS) for inflammation, Ki-67 for proliferation, and type II collagen for regeneration was performed. Medial femoral cartilage was stained with Safranin-O/Fast Green and evaluated with the Osteoarthritis Research Society International score at 8 and 16 weeks.
The wrapping group had significantly better regeneration than the horizontal group, especially at 16 weeks ( < 0.05). Wrapping treatment induced fibrochondrocyte-like cells at 16 weeks. After wrapping treatment, iNOS was overexpressed at 8 weeks, Ki-67 at 8 and 12 weeks, and type II collagen at 16 weeks. Cartilage degeneration in the wrapping group did not progress significantly compared with that in the horizontal group at 16 weeks ( < 0.05).
Wrapping treatment for meniscal horizontal tears induced meniscal regeneration as the sheet scaffold might induce intrinsic and extrinsic repair. Regaining the meniscal function by the wrapping treatment prevented cartilage degeneration.
采用包裹法治疗兔半月板水平撕裂,以促进半月板再生并预防软骨退变,从而为半月板水平撕裂的修复提供一种新的方法。
15 只日本大耳白兔的 30 个膝关节随机分为水平撕裂(水平撕裂组)或包裹(水平撕裂加包裹组)组。在半月板水平撕裂处包裹一层含有聚乙醇酸、聚乳酸和聚己内酯的支架片。术后 8、12、16 周(每组 n = 5)时,用改良 Pauli 评分法对半月板进行染色评估,并用苏木精-伊红染色法观察细胞形态,用苦味酸天狼猩红染色法检测成熟胶原,并用免疫组化法检测诱导型一氧化氮合酶(iNOS)、Ki-67 和Ⅱ型胶原以评估炎症、增殖和再生情况。术后 8 和 16 周时,用番红 O/快绿染色法评估内侧股骨软骨,并采用国际骨关节炎研究协会(OARSI)评分进行评估。
包裹组的再生效果明显优于水平撕裂组,尤其是在术后 16 周时( P < 0.05)。包裹组在术后 16 周时可见纤维软骨样细胞。包裹治疗 8 周时 iNOS 高表达,8、12 周时 Ki-67 高表达,16 周时Ⅱ型胶原高表达。与水平撕裂组相比,包裹组在术后 16 周时软骨退变无明显进展( P < 0.05)。
包裹法治疗半月板水平撕裂可诱导半月板再生,支架片可能通过内源性和外源性修复机制促进半月板再生,从而恢复半月板的功能,预防软骨退变。