Objective To investigate the influence on costal cartilage reparative regeneration by replanting the small blocks of autogeneic cartilage into the perichondrial pocket at the donor-site. Methods 16 rabbits (8-10 weeks old, 1.8-2. 2 kg) were randomly divided into four groups as three experimental groups and one control group. The 1.5 cm in length of costal cartilage defect was made in experimental groups with the perichondrium and costochondral junction left completely intact. The cartilage defect was cloesd by 3 methods as suturation directly, or replanting the small blocks of autogeneic cartilage, or plugging bioprotein jelly after cartilage replanting. Each experimental group was handled with two methods in two sides of costal cartilage. No operation was performed in control group. All the rabbits were sacrificed 16 weeks after operation. The appearance of thoracic cage and new-formed tissue at the defect site were examined grossly. Haematoxylin-eosin staining was performed to evaluate the characteristics of new-formed tissues and biomechanical detection was used to measure intension of new-formed tissues. Results The appearance of thoracic cage was normal in every experimental group. Histological study showed that the defect was filled with abundant fibrous tissue in each group. The chipping of cartilage survived effectively with little proliferation. Biomechanical detection showed that the intension of new-formed tissue in the non replanted group [( 193. 92 ± 41. 41 ) N] was obviously less than that in the replanted group [( 318. 88 ±28. 28)N] ,or bioprotein jelly group[(301. 00 ±39. 52) N] , or control group[(300. 54 ±38. 35) N] (P <0. 01). Furthermore, there was no statistical difference between the latter three groups ( P > 0. 05 ) . Conclusions Although replanting the chipping of cartilage can' t promote reparative regeneration of hyaline cartilage, it can definitively strengthen the intensity of new-formed tissue, reinforce thoracic stability. It may also indirectly decrease the incidence rate of postoperative chest wall deformity.%目的 研究切取自体肋软骨后将软骨碎屑回植包埋人供区软骨膜内,对肋软骨修复和再生的影响.方法 取8～10周龄生长期雄性家兔16只随机分成4组,每组4只.实验各组在完整保留软骨膜、肋骨软骨连结处的情况下切取一段肋软骨,对缺损部位采用直接缝合、软骨碎屑回植后缝合及软骨碎屑回植加生物蛋白胶封闭空隙后缝合3种方法处理,3种处理方法在各实验组家兔两侧肋软骨中两两配对;健康对照组不做任何处理.术后16周处死家兔后观察各组胸廓及修复段的大体形态,常规HE染色病理切片,并行生物力学检测测定各肋软骨修复段的强度.结果 各实验组家兔的胸廓整体形态均较良好,各组及各处理方法之间并无明显差别;HE染色病理切片观察可见各组修复组织均主要为纤维组织,回植的小块软骨虽能够有效存活,但无明显增殖.生物力学检测显示:不回植组的修复组织强度为(193.92±41.41)N、回植组为(318.88±28.28)N、生物蛋白胶组为(301.00±39.52)N、健康对照组为(300.54±38.35)N,不回植组明显低于后3组(P<0.01).而后3组组间比较差异均无统计学意义(P>0.05).结论 将软骨碎屑回植虽不能促进透明软骨的再生修复,但能明显加强修复组织的强度,加强胸廓的稳定性,从而间接降低胸廓畸形的发生率.
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