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单髁双极骨软骨和半月板同种异体移植治疗犬膝关节内侧间室骨关节炎模型有效。

Unicompartmental bipolar osteochondral and meniscal allograft transplantation is effective for treatment of medial compartment gonarthrosis in a canine model.

机构信息

Thompson Laboratory for Regenerative Orthopaedics, Orthopaedic Research Division, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri.

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

出版信息

J Orthop Res. 2021 May;39(5):1093-1102. doi: 10.1002/jor.24801. Epub 2020 Jul 27.

DOI:10.1002/jor.24801
PMID:32672863
Abstract

Osteochondral allograft (OCA) transplantation can restore large articular defects in the knee. Bipolar OCA transplantations for partial and whole joint resurfacing often have less favorable results than single-surface transplants. This study was designed to use a large animal model to test the hypothesis that unicompartmental bipolar osteochondral and meniscal allograft transplantation (BioJoint) would be as or more effective for treatment of medial compartment osteoarthritis (OA) compared to standard-of-care nonoperative treatment. OA was induced in one knee of each research hound (n = 8) using a meniscal release model and pretreatment assessments were performed. After 3 months, dogs were randomly assigned to either the control group (n = 4, no surgical intervention, daily nonsteroidal antiinflammatory drugs [NSAIDs]) or the BioJoint group (n = 4). Clinical, radiographic, and arthroscopic assessments were performed longitudinally and histopathology was evaluated at the 6-month endpoint. At study endpoint, functional, pain, and total pressure index measures, as well as radiographic and arthroscopic grading of graft appearance and joint health, demonstrated superior outcomes for BioJoints compared to NSAID controls. Furthermore, histologic assessments showed that osteochondral and meniscal transplants maintain integrity and integrated into host tissues. Clinical significance: The results support the safety and efficacy of unicompartmental bipolar osteochondral and meniscal allograft transplantation in a preclinical model with highly functional outcomes without early OA progression.

摘要

异体骨软骨移植(OCA)可修复膝关节大关节缺损。双极 OCA 移植用于部分和全关节表面置换的效果往往不如单表面移植。本研究旨在使用大动物模型来检验以下假设:与标准护理非手术治疗相比,单室双极骨软骨和半月板同种异体移植(BioJoint)在治疗内侧间室骨关节炎(OA)方面同样有效或更有效。使用半月板切除模型在每只研究猎犬(n = 8)的一只膝关节中诱导 OA,并进行预处理评估。3 个月后,狗被随机分配到对照组(n = 4,无手术干预,每日非甾体抗炎药 [NSAIDs])或 BioJoint 组(n = 4)。进行了纵向临床、放射学和关节镜评估,并在 6 个月终点评估了组织病理学。在研究终点,功能、疼痛和总压力指数测量以及移植物外观和关节健康的放射学和关节镜分级显示,与 NSAID 对照组相比,BioJoints 的结果更好。此外,组织学评估显示,骨软骨和半月板移植物保持完整性并整合到宿主组织中。临床意义:结果支持单室双极骨软骨和半月板同种异体移植在具有高度功能结果的临床前模型中的安全性和有效性,而没有早期 OA 进展。

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