Robinson P D
Department of Oral and Maxillofacial Surgery, UMDS, London.
Ann R Coll Surg Engl. 1993 Jul;75(4):231-6.
Clinical evidence and previous experimental animal work suggest that mandibular condylar cartilage shows the capacity for repair, after trauma or degeneration, that can reconstitute a functional articular surface; a facility not shared by other synovial joints. This study aims to test the regenerative capability of condylar cartilage in the repair of standardised full-thickness articular defects, and thereby to test the hypothesis that the healed wounds comprise tissues identical in form and composition to those of similar, but uninjured areas. Articular defects were produced at open arthrotomy of the temporomandibular joints in the young adult cotton eared marmoset. After healing periods of between 3 days and 1 year, repairing wounds were examined using histological, autoradiographic and immunocytochemical methods in an attempt to identify tissue architecture, cell proliferation and cartilage matrix components. The results showed reconstitution of all tissue elements of condylar cartilage within 6 months of injury. Glycosaminoglycans reformed at an early stage and appeared to be associated with type I collagen fibrillogenesis. Subsequently, type II collagen and aggregated proteoglycans accumulated from 8 weeks postoperatively, coinciding with organisation of the cell layers of condylar cartilage. The reformed tissue was maintained intact for the period studied (up to 1 year).
临床证据和先前的实验动物研究表明,下颌髁突软骨在创伤或退变后具有修复能力,能够重建功能性关节表面;这是其他滑膜关节所没有的能力。本研究旨在测试髁突软骨在修复标准化全层关节缺损中的再生能力,从而验证愈合伤口的组织在形态和组成上与相似但未受伤区域的组织相同这一假设。在成年幼年棉耳狨猴的颞下颌关节开放性关节切开术中制造关节缺损。在3天至1年的愈合期后,使用组织学、放射自显影和免疫细胞化学方法检查修复伤口,试图确定组织结构、细胞增殖和软骨基质成分。结果显示,损伤后6个月内髁突软骨的所有组织成分均得以重建。糖胺聚糖在早期重新形成,似乎与I型胶原纤维形成有关。随后,II型胶原和聚集蛋白聚糖在术后8周开始积累,这与髁突软骨细胞层的组织化同时发生。在研究期间(长达1年),重建的组织保持完整。