The rabbit models of osteochondral defects were established and two methods of treatment with external injection of sodium hyaluronate and subchondral bone drilling were adopted,the repair effect and early repair mechanism of these two methods were compared to provide experimental basis for clinical application.The models of articular cartilage injury in 36 Harbin White rabbits were set up and randomly allocated to three groups:Self-healing group (negative control),medication group (sodium hyaluronate injection) and drilling group (subchondral bone drilling).Rabbits from each group were sacrificed 1,4,6 and 8 weeks after operation,RT-PCR method was adopted to detect Col Ⅰ,Col Ⅱ,Col X,Agg,and Runx2 genes expression of repaired articular cartilage tissues;Postoperative 8 weeks,cartilage specimen were observed with HE staining,safranin green staining and toluidine blue staining to analyze the repair effect and repair mechanism of the three groups.The results showed that the cartilage damage of the two experimental groups were significantly repaired,staining showed that the chondrocytes in repaired tissues increased with typical cartilage lacuna like structure,the positive staining of medication group was better than drilling group.The expression of cartilage specificity genes Agg and Col Ⅱ mRNA in medication group was significatly higher than that in drilling group (P＜0.05).The expression of Col X and Runx2 of drilling group were more active than medication group (P＜0.05).The expression of major components of fibrous tissue,Col Ⅰ,self-healing group was the highest,then in drilling group,medication group was the lowest.The results showed that medication and drilling could repair the defects of the whole layer cartilage defects in various degrees.The main component of the restorations was fibrous tissue in self-healing group,more hyaline cartilage were produced by treated with hyaluronic acid and a thin layer of fibrous cartilage covering the surface of repair tissues in drilling group.In conclusion,in the short-term repair of bone defect,the effect of sodium hyaluronate was better than that of drilling.%试验通过建立兔部分软骨损伤模型,采用外源性注射透明质酸钠和软骨下钻孔两种治疗方法,比较两种方法的修复效果及早期修复机制,为临床应用提供试验依据.试验选用36只哈白兔建立膝关节软骨损伤模型后随机均分为3组:自愈组(阴性对照)、用药组(透明质酸钠注射)、钻孔组(软骨下钻孔).术后1、4、6、8周,采用RT-PCR方法检测修复物中Ⅱ型胶原(ColⅡ)、蛋白聚糖(Agg)、Ⅹ型胶原(Col Ⅹ)、Ⅰ型胶原(Col Ⅰ)及Runx2的mRNA表达量;术后8周,制作软骨切片进行HE染色、番红—固绿染色和甲苯胺蓝染色,分析3组的修复效果及修复机制.结果显示,两试验组软骨损伤都被明显修复,染色结果显示修复组织中软骨细胞增多,具有软骨典型的陷窝样结构,用药组阳性着色优于钻孔组.用药组软骨的特异性基因Agg和ColⅡ的mRNA表达量显著高于钻孔组(P＜0.05),软骨细胞肥大相关基因Col Ⅹ和Runx2的表达量显著低于钻孔组(P＜0.05).自愈组Col Ⅰ的mRNA表达量最高,钻孔组次之,用药组最低.试验结果表明,用药及钻孔对关节软骨损伤都有不同程度的治疗修复作用,自愈组修复物成分主要为纤维组织,透明质酸钠治疗后产生了较多的透明软骨成分,而钻孔修复后的表层覆盖薄层纤维软骨成分,在骨缺损短期修复中,透明质酸钠的修复效果优于钻孔疗法.
展开▼
