Bruns J, Kahrs J, Kampen J, Behrens P, Plitz W
Department of Orthopaedic Surgery, University of Hamburg, Germany.
J Bone Joint Surg Br. 1998 Sep;80(5):918-23. doi: 10.1302/0301-620x.80b5.8023.
Our aim was to examine the potential of autologous perichondral tissue to form a meniscal replacement. In 18 mature sheep we performed a complete medial meniscectomy. The animals were then divided into two groups: 12 had a meniscal replacement using strips of autologous perichondral tissue explanted from the lower rib (group G) and six (group C) served as a control group without a meniscal replacement. In all animals restriction from weight-bearing was achieved by means of transection and partial resection of tendo Achillis. Six animals (four from group G and two from group C) were each killed at 3, 6 and 12 months. The grafts and the underlying articular cartilage were removed and studied by gross macroscopic examination, light microscopy, SEM, polarised light examination, and by biomechanical tests. In all the transplanted animals a new perichondral meniscus developed. After three months the transplants resembled normal menisci in size and thickness, while in the control animals only small rims of spontaneously grown tissue were seen. Microscopically, the perichondral menisci showed a normal orientation of collagen fibres and normal cellular characteristics, but in the central region, areas of calcification disturbed the regular tissue differentiation. Healing tissue in control animals lacked the normal fibre orientation and cellularity. SEM of perichondral menisci showed surface characteristics similar to those of normal sheep menisci without fissures and lacerations; the control specimens had these defects. The femoral and tibial cartilage in contact with the new menisci had normal surface characteristics apart from one animal with slight surface irregularities. Control animals showed superficial lesions after three months which increased at six to 12 months postoperatively. Microangiography of the newly grown tissue demonstrated a less intense vascularisation after three months when compared with normal menisci. The failure stress and tensile modulus of perichondral menisci were significantly lower than those of normal contralateral menisci, and spontaneously regenerated tissue in meniscectomised animals had even lower values. There were no significant differences in values between newly grown perichondral menisci and spontaneously grown tissue.
我们的目的是研究自体软骨膜组织形成半月板替代物的潜力。对18只成年绵羊进行了内侧半月板全切除术。然后将这些动物分为两组：12只使用从下肋骨取出的自体软骨膜组织条进行半月板置换（G组），6只（C组）作为未进行半月板置换的对照组。通过切断和部分切除跟腱，对所有动物进行负重限制。分别在3个月、6个月和12个月时处死6只动物（4只来自G组，2只来自C组）。取出移植物和其下方的关节软骨，通过大体肉眼检查、光学显微镜检查、扫描电子显微镜检查、偏振光检查和生物力学测试进行研究。在所有移植动物中均形成了新的软骨膜半月板。3个月后，移植物在大小和厚度上类似于正常半月板，而在对照动物中仅可见自发生长组织的小边缘。显微镜下，软骨膜半月板显示胶原纤维排列正常且细胞特征正常，但在中央区域，钙化区域干扰了正常的组织分化。对照动物中的愈合组织缺乏正常的纤维排列和细胞结构。软骨膜半月板的扫描电子显微镜检查显示其表面特征与正常绵羊半月板相似，无裂缝和撕裂伤；对照标本有这些缺陷。与新半月板接触的股骨和胫骨软骨，除一只动物有轻微表面不规则外，表面特征正常。对照动物在3个月后出现浅表损伤，术后6至12个月损伤加重。新生长组织的微血管造影显示，与正常半月板相比，3个月后血管化程度较低。软骨膜半月板的破坏应力和拉伸模量明显低于对侧正常半月板，半月板切除动物中的自发再生组织的值甚至更低。新生长的软骨膜半月板与自发生长组织之间的值无显著差异。
