Frings Jannik, Baranowsky Anke, Korthaus Alexander, Berninger Markus T, Frosch Karl-Heinz, Fahlbusch Hendrik, Fal Milad Farkondeh, Ondruschka Benjamin, Buhs Matthias, Keller Johannes, Krause Matthias
Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany.
Arthroscopy. 2025 Mar;41(3):762-770. doi: 10.1016/j.arthro.2024.05.020. Epub 2024 Sep 2.
To characterize and compare the quality of regenerative cartilage tissue (ReCT) after conventional minced cartilage (CMC) and arthroscopic minced cartilage (AMC), in terms of cell viability, gene expression, and matrix synthesis and to investigate the influence of different shaver types.
Chondral tissue was harvested from the knees of 8 porcine donors. Porcine specimens were euthanized one day before harvest. AMC was created with 2 shaver blades in 2 operating modes (oscillating vs forward) and compared with a scalpel-fragmented CMC control. Before histologic analysis, 50% of the tissue was digested to prevent dedifferentiation of chondrocytes to fibroblasts. Cells were cultured and analyzed for cell viability, gene expression of cartilage-specific markers (aggrecan [ACAN], collagen type II, alpha1 [COL2A1], collagen type I, alpha1 [COL1A1], fibronectin-1 [FN1]), and matrix synthesis (Alcian-blue).
AMC tissue contained fewer viable chondrocytes (41%-54% vs 91%; P = .001-.048) compared with CMC. After culture, CMC showed greater expressions of ACAN (27 virtual copy numbers [VCN]/housekeeping gene) and COL2A1 (30 VCN) compared with AMC (ACAN 2-9 VCN, COL2A1 2-7 VCN, P = .001-.039). AMC presented greater expressions of COL1A1 (9-21 VCN) and FN1 (12-17 VCN) than CMC (1 and 6 VCN, P = .001-.050). The signal intensity of the cartilage matrix formed by CMC (86/mm) was greater than by AMC (7-10 mm, P = .001-.032).
CMC contained high numbers of viable chondrocytes, resulting in high-quality, hyaline-like ReCT. In contrast, AMC showed impaired chondrocyte quantity and viability, showing greater expressions of fibroblast markers and a decreased formation of mature cartilage matrix in porcine samples. The high chondrogenic potential of CMC to form hyaline-like ReCT was not confirmed for AMC.
On the basis of our findings, arthroscopic harvest of minced cartilage leads to reduced chondrocyte viability and ReCT quality. Accordingly, CMC and AMC cannot be regarded as synonymous techniques, as arthroscopic techniques seem to be less efficacious.
从细胞活力、基因表达和基质合成方面，对传统切碎软骨（CMC）和关节镜下切碎软骨（AMC）后的再生软骨组织（ReCT）质量进行表征和比较，并研究不同刨削器类型的影响。
从8只猪供体的膝关节获取软骨组织。猪标本在取材前一天安乐死。使用2种刨削器刀片以2种操作模式（摆动式与推进式）制作AMC，并与手术刀切碎的CMC对照进行比较。在组织学分析前，将50%的组织进行消化以防止软骨细胞去分化为成纤维细胞。培养细胞并分析细胞活力、软骨特异性标志物（聚集蛋白聚糖[ACAN]、Ⅱ型胶原α1链[COL2A1]、Ⅰ型胶原α1链[COL1A1]、纤连蛋白-1[FN1]）的基因表达以及基质合成（阿尔辛蓝）。
与CMC相比，AMC组织中存活的软骨细胞较少（41%-54%对91%；P = 0.001-0.048）。培养后，与AMC相比，CMC中ACAN（27个虚拟拷贝数[VCN]/看家基因）和COL2A1（30个VCN）的表达更高（ACAN 2-9个VCN，COL2A1 2-7个VCN，P = 0.001-0.039）。AMC中COL1A1（9-21个VCN）和FN1（12-17个VCN）的表达高于CMC（1个和6个VCN，P = 0.001-0.050）。CMC形成的软骨基质信号强度（86/mm）大于AMC（7-10/mm，P = 0.001-0.032）。
CMC含有大量存活的软骨细胞，可形成高质量的透明样ReCT。相比之下，AMC显示软骨细胞数量和活力受损，在猪样本中显示成纤维细胞标志物表达更高，成熟软骨基质形成减少。AMC未证实具有CMC形成透明样ReCT的高软骨形成潜力。
基于我们的研究结果，关节镜下获取切碎软骨会导致软骨细胞活力和ReCT质量降低。因此，CMC和AMC不能被视为同义技术，因为关节镜技术似乎效果较差。
