Shim Dong Woo, Lee Kyoung-Mi, Lee Donghyun, Kim Jun Sik, Jung Yeon Seop, Oh Sung Suk, Lee Si Wook, Lee Jin Woo, Kim Bom Soo
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
Department of Medicine, Inha Graduate School, Incheon, Korea.
Cartilage. 2025 Mar;16(1):61-70. doi: 10.1177/19476035231199442. Epub 2023 Sep 12.
Treatment strategies for osteochondral defects, for which particulated autologous cartilage transplantation (PACT) is an emerging treatment strategy, aim to restore the structure and function of the hyaline cartilage. Herein, we compared the efficacy of PACT with control or human transforming growth factor-β (rhTGF-β), and clarified the necessity of bone graft (BG) with PACT to treat shallow osteochondral defects in a porcine model.
Two skeletally mature male micropigs received 4 osteochondral defects in each knee. The 16 defects were randomized to (1) empty control, (2) PACT, (3) PACT with BG, or (4) rhTGF-β. Animals were euthanized after 2 months and histomorphometry, immunofluorescence analysis, semiquantitative evaluation (O'Driscoll score), and magnetic resonance observation of cartilage repair tissue (MOCART) score were performed.
Hyaline cartilages, glycosaminoglycan synthesis, and collagen type II staining were more abundant in the PACT than in the control and rhTGF-β groups. The O'Driscoll score was significantly different between groups ( < 0.001), with both PACT groups showing superiority ( = 0.002). PACT had the highest score ( = 0.002), with improved restoration of subchondral bone compared with PACT with BG. The MOCART score showed significant differences between groups ( = 0.021); MOCART and O'Driscoll scores showed high correlation (r = 0.847, < 0.001).
Treatment of osteochondral defects with PACT improved tissue quality compared with that with control or rhTGF-β in a porcine model. BG, in addition to PACT, may be unnecessary for shallow osteochondral defects. BG may not be necessary while performing PACT.
对于骨软骨缺损，颗粒状自体软骨移植（PACT）是一种新兴的治疗策略，其治疗策略旨在恢复透明软骨的结构和功能。在此，我们比较了PACT与对照组或重组人转化生长因子-β（rhTGF-β）的疗效，并阐明了在猪模型中使用PACT治疗浅层骨软骨缺损时植骨（BG）的必要性。
两只骨骼成熟的雄性小型猪每只膝关节接受4处骨软骨缺损。将16处缺损随机分为（1）空白对照组、（2）PACT组、（3）PACT联合BG组或（4）rhTGF-β组。2个月后对动物实施安乐死，并进行组织形态计量学分析、免疫荧光分析、半定量评估（奥德里斯科尔评分）以及对软骨修复组织进行磁共振观察（MOCART评分）。
PACT组的透明软骨、糖胺聚糖合成以及Ⅱ型胶原染色比对照组和rhTGF-β组更丰富。组间奥德里斯科尔评分存在显著差异（<0.001），两个PACT组均显示出优势（=0.002）。PACT组评分最高（=0.002），与PACT联合BG组相比，其软骨下骨的修复更好。MOCART评分在组间存在显著差异（=0.021）；MOCART评分与奥德里斯科尔评分显示出高度相关性（r = 0.847，<0.001）。
在猪模型中，与对照组或rhTGF-β相比，用PACT治疗骨软骨缺损可改善组织质量。对于浅层骨软骨缺损，除PACT外可能无需BG。在进行PACT时可能不需要BG。
