Onodera Tomohiro, Baba Rikiya, Kasahara Yasuhiko, Tsuda Toshihiko, Iwasaki Norimasa
Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan.
Global Station for Soft Matter, Global Institution for Collaborative Research and Education (GSS, GI-CoRE), Hokkaido University, Sapporo, Japan.
Regen Ther. 2020 Feb 20;14:154-159. doi: 10.1016/j.reth.2020.01.001. eCollection 2020 Jun.
The aim of this study was to clarify the objective therapeutic effects of an acellular technique by ultrapurified alginate (UPAL) gel implantation in canine osteochondral defect models.
Two osteochondral defects (diameters: 3.0 and 5.0 mm) were created on each patellar groove in both knees of 10 dogs. Defects were divided into four groups (n = 10 each): Group 1, untreated 3.0-mm defect; Group 2, 3.0-mm defect with UPAL gel; Group 3, untreated 5.0-mm defect; and Group 4, 5.0-mm defect with UPAL gel. All surgical procedures were performed by individuals unfamiliar with the technique at an independent institution. Articular surfaces were evaluated grossly and histologically at 27 weeks after operation.
UPAL gel-treated osteochondral defects showed significantly improved gross appearance in Group 4 and histological appearance in Groups 2 and 4. Reparative tissues in the 3.0-mm defect with UPAL gel were replaced by hyaline-like cartilage tissue. The 5.0-mm defects with UPAL gel were mostly covered with fibrocartilaginous tissue, whereas UPAL gel-untreated defects mostly remained uncovered by any tissue.
Although an acellular technique using UPAL gel implantation significantly enhanced osteochondral repair in canines, reparative tissues of the large defect with alginate gel comprised of fibrocartilaginous tissue. This surgical technique is effective, especially for small cartilage injuries. Further improvements are required before clinical application in cases of severe osteochondral defects in humans.
本研究的目的是阐明在犬类骨软骨缺损模型中通过超纯化藻酸盐（UPAL）凝胶植入的脱细胞技术的客观治疗效果。
在10只犬的双膝关节的每个髌沟上制造两个骨软骨缺损（直径：3.0和5.0毫米）。缺损分为四组（每组n = 10）：第1组，未治疗的3.0毫米缺损；第2组，3.0毫米缺损用UPAL凝胶治疗；第3组，未治疗的5.0毫米缺损；第4组，5.0毫米缺损用UPAL凝胶治疗。所有手术操作均由独立机构中不熟悉该技术的人员进行。在术后27周对关节表面进行大体和组织学评估。
UPAL凝胶治疗的骨软骨缺损在第4组中显示出明显改善的大体外观，在第2组和第4组中显示出组织学外观改善。用UPAL凝胶治疗的3.0毫米缺损中的修复组织被透明样软骨组织替代。用UPAL凝胶治疗的5.0毫米缺损大多被纤维软骨组织覆盖，而未用UPAL凝胶治疗的缺损大多仍未被任何组织覆盖。
尽管使用UPAL凝胶植入的脱细胞技术显著增强了犬类的骨软骨修复，但藻酸盐凝胶治疗的大缺损的修复组织由纤维软骨组织组成。这种手术技术是有效的，特别是对于小的软骨损伤。在临床应用于人类严重骨软骨缺损病例之前，还需要进一步改进。
