早期体内力学刺激促进藻酸钙复合自体软骨细胞修复羊关节负重区软骨缺损的实验研究

摘要

目的 观察膝关节持续被动活动仪(CPM)体内力学刺激对组织工程软骨修复大动物关节负重区软骨缺损效果的影响.方法 研究、设计和制造能够适用于体内力学刺激羊膝关节软骨缺损修复的膝关节连续被动活动仪(CPM);将实验动物(山羊膝关节双髁负重区制造直径6 mm软骨缺损)分为三组:空白组:单纯缺损未植入修复组织;藻酸钙+骨膜+细胞组:藻酸钙复合自体软骨细胞凝胶植入软骨缺损区,自体骨膜覆盖缺损区;藻酸钙+骨膜+细胞+CPM组:藻酸钙复合自体软骨细胞凝胶植入软骨缺损区,自体骨膜覆盖缺损区,术后早期接受CPM锻炼.分别于术后3个月、6个月、12个月(12个月组仅包括CPM力学刺激组)取材,通过修复组织的大体、组织学观察及其评分比较3组软骨修复效果.结果 藻酸钙复合软骨细胞能够较好地修复羊负重区关节面软骨缺损,将缺损修复的大体观察、组织学等结果进行单因素统计学分析,发现接受体内CPM力学刺激组效果最好,其修复组织中透明软骨比例最多,其次为藻酸钙+骨膜+细胞组.结论 膝关节持续被动活动仪(CPM)体内力学刺激能够促进组织工程软骨修复大动物关节负重区软骨缺损的效果.%Objective To observe the effect of mechanical stimulation of continuous passive motion (CPM) on repairing articular bearing area cartilage defects of large animals. Methods① The designed and prepared continuous passive motion could be applied toin vivo mechanical stimulation in repairing goat articular cartilage defects of the knee joint.② A full-thickness articular-cartilage defect (6 mm in diameter) was created in the femoral condyle weight-bearing area of goats. The goats were divided into three groups A, B and C. A was control group of cartilage damaged in the weight area of the knee joint without implantation. B was calcium alginate + periosteum + cells group of cartilage damaged in the weight area of the knee joint repaired by calcium alginate composite chondrocytes and periosteum. C was calcium alginate + periosteum + cells + CPM group of cartilage damaged in the weight area of the knee joint repaired by calcium alginate composite chondrocytes and periosteum with early CPM exercise postoperatively. Results of cartilage repair were assessed after 3, 6 months and 12 months (12 months group only treated by CPM group) by the general, histological observation and score of the repair of tissue. Results Calcium alginate composite cartilage cells was able to repair injuried cartilages in the weight area of the goat knee joint. The results of a single factor statistical analysis of the gross and histology observation from defect repair revealed that the effect of CPM mechanical stimulation group was the best, followed by calcium alginate + periosteum + cells group. Conclusion Mechanical stimulation of continuous passive motion can promote injuried articular cartilage repair of large animals.