Naito K
Department of Orthopaedics, Shimane Medical School, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1995 Sep;69(9):767-75.
We report the results of chondrogenesis from a free autograft of periosteum taken from the medial tibial condyle transplanted over a partial-thickness defect created on the medial femoral articular surface in immature white rabbit. A total of 69 rabbits were randomly divided into four groups as follows, Group I received the free autograft and were allowed intermittent activity in a cage. Group II also received a free autograft but were allowed only continuous passive motion in a CPM apparatus for 8 hours a day for the first two weeks after the operation. Group III received a freeze-dried periosteal graft and were allowed intermittent activity in a cage. And Group IV as controls received no graft over the created defect and were allowed intermittent activity in a cage. In specimens from Group I and from Group II at 3 weeks postoperatively, hypertrophic cells were recognized. In both groups at 4 weeks postoperatively, the autograft had sealed the defect with interposition of fiber bundles. At 8 weeks postoperatively, the union of both matrices was clearly demonstrated. The chondrocyte arrangement and matrix bonding was observed to be better in Group II than in Group I. In specimens from Group III at 8 weeks postoperatively, the freeze-dried periosteum had deteriorated without sealing the defect. In Group IV at 8 weeks postoperatively, the surface of the shaved cartilage was irregular and similar to that in arthrosis. These findings indicated that a periosteal free autograft produced bonding between the matrix of the graft and the matrix of the host cartilage, and was therefore effective for chondrogenesis to seal over a joint defect.
我们报告了取自未成熟白色家兔内侧胫骨髁的骨膜游离自体移植在股骨内侧关节面部分厚度缺损上进行软骨形成的结果。总共69只家兔被随机分为以下四组,第一组接受游离自体移植,并允许在笼中进行间歇性活动。第二组也接受游离自体移植,但在术后前两周仅允许每天在连续被动运动(CPM)装置中进行8小时的连续被动运动。第三组接受冻干骨膜移植,并允许在笼中进行间歇性活动。第四组作为对照组,在创建的缺损处不进行移植,并允许在笼中进行间歇性活动。在术后3周时,第一组和第二组的标本中均识别出肥大细胞。在术后4周时,两组中的自体移植均通过纤维束的插入封闭了缺损。在术后8周时,清楚地显示了两种基质的结合。观察到第二组中的软骨细胞排列和基质结合比第一组更好。在术后8周时,第三组的标本中,冻干骨膜已经退化,未封闭缺损。在术后8周时,第四组中,剃除软骨的表面不规则,与关节炎中的表面相似。这些发现表明,骨膜游离自体移植在移植基质与宿主软骨基质之间产生了结合,因此对于软骨形成以封闭关节缺损是有效的。