异种异体半月板移植延缓关节软骨退行性变的研究  

Could Xenogenic Meniscus Transplantation Delay Degeneration of Articular Cartilage

作　　者：谢兴[1] 张继英[1] 傅欣[1] 余家阔[1] 敖英芳[1] 于长隆[1] 

机构地区：[1]北京大学第三医院运动医学研究所,北京100083

出　　处：《中国运动医学杂志》2006年第3期290-293,i0003,共5页Chinese Journal of Sports Medicine

基　　金：北京大学医学部"985"工程Ⅱ期建设项目资助

摘　　要：目的:探讨异种异体半月板移植对延缓关节软骨退变的作用。方法:对15只成年新西兰兔的后肢左、右膝均进行内侧半月板全切。在15只兔的左膝进行猪半月板组织成型后所得的异种异体内侧半月板移植,以其已切除内侧半月板的右膝作为对照。分别于术后6周、12周、24周择期处死动物,观察各组兔膝关节软骨的大体病理表现、组织病理Mankin评分改变,并用Ⅰ、Ⅱ、Ⅲ、Ⅹ型胶原单克隆抗体免疫组织化学染色法观察关节软骨中Ⅰ、Ⅱ、Ⅲ、Ⅹ型胶原的表达情况。结果:兔内侧半月板全切组膝内侧胫骨平台和内侧股骨髁软骨破坏严重,有大量骨赘形成,呈骨性关节炎表现。异种异体半月板移植在短期内对关节软骨具有明显保护作用,但随着术后24周移植半月板被破坏,关节软骨出现退变,但与同期的半月板切除膝相比,关节软骨退变较轻。结论:异种异体半月板移植短期内对关节软骨有保护作用;异种异体半月板移植可延缓关节软骨退行性变。Objective To compare the difference in articular cartilage degeneration between xenogenic medial meniscus transplantation and total medial meniscectomy in order to understand whether xenogenic medial meniscus transplantation could delay the degeneration of articular cartilage. Methods Total medial meniscectomy was performed on all of the left and right knees of 15 adult New Zealand white rabbits, pig meniscus tissue was used as xenogenic grafts to display medial menisci of the rabbits in 15 left knees. The fight knees without medial menisci were used as control group. The rabbits were sacrificed at 6, 12 and 24 weeks after surgery. The macroscopic pathology and histopathologic Mankin score of the articular cartilage were observed. Articular cartilage immunohistochemical staining with monoclonal antibodies of the type Ⅰ , Ⅱ , Ⅲ and Ⅹ collagens was conducted to observe the collagens expression in the articular cartilage. Articular cartilage degeneration status was evaluated. Results In total medial meniscectomy group, serious cartilage injury was found in the medial femoral condyles and the medial tibial plateaus. Many osteophytes appeared on the edge of the medial femoral condyles and the medial tibial plateaus, and osteoarthritis occurred. Xenogenic meniscus transplantation could shortly protect articular cartilage. Cartilage degeneration began while the implanted xenogenic meniscus was destroyed. After operation, the cartilage degeneration was milder in xenogenic group than that in meniscectomy group. Conclusion Transplantation of xenogenic medial meniscus molded from pig meniscus tissue could protect cartilage shortly. 24 weeks after surgery, the implanted meniscus was almost destroyed, the cartilage degeneration appeared simultaneously, but was milder than that in the meniscectomy group. Xenogenic meniscus transplantation could delay articular cartilage degeneration.

关 键 词：异种异体半月板 半月板移植 半月板切除 关节软骨 骨性关节炎 

分 类 号：R87[医药卫生—运动医学]