孔直径不同的软骨下骨钻孔术对兔软骨缺损修复的影响  

INFLUENCE OF SUBCHONDRAL DRILLING WITH DIFFERENT DIAMETER OF HOLES ON THE REPAIR OF ARTICULAR CARTILAGE DEFECT IN RABBITS

作　　者：葛志强[1] 杨洪锋 王宝生[1] 张金平[1] 曹化祥[1] 雷学锋[1] 廉平[1] 叶建[1] 祝海州[1] 

机构地区：[1]济宁医学院外科学教研室

出　　处：《济宁医学院学报》1996年第2期6-9,共4页Journal of Jining Medical University

基　　金：中华医学基金

摘　　要：为了观察钻孔修复关节软骨缺损的过程，比较不同孔直径钻孔术对软骨缺损的修复效果，用中国白兔２４只，在股骨关节面造成６ｍｍ×８ｍｍ全层软骨缺损，分别施行孔直径１ｍｍ和１．５ｍｍ的钻孔术，术后４、８周取材，做组织学光、电镜观察并进行评估。结果表明：①两组的优势修复组织均为类透明软骨、幼稚软骨和纤维软骨，对照组为纤维组织。②修复组织厚度，１ｍｍ孔比１．５ｍｍ孔较厚，０．１＞Ｐ＞０．０５。③修复组织覆盖缺损的面积，两组间无显著性差异。初步结论：软骨下骨钻孔可修复关节软骨全层缺损；小孔比大孔修复效果好；非钻孔的缺损修复效果差。（Ａ）与（Ｂ）、（Ｃ）比较，分别为：Ｐ＜０．０５和Ｐ＜０．０１：（Ｂ）与（Ｃ）比较：Ｐ＜０．０１。２．３．４电镜观察结果，术后４周各组均可见到纤维细胞，细胞较少，呈梭形散在分布于较粗大的胶原纤维中；术后８周，各孔组均可见透明样软骨细胞（图５）和纤维软骨细胞，对照组为肉芽组织。图５钻孔术后８周，可见透明样软骨细胞（透身电镜×４０００）３讨论自从１９６２年Ｃａｌａｎｄｒａｃｃｉｏ在幼犬股骨踝部用环钻作洞，发现缺损由迅速长出的肉芽组织填充后，导致钻孔治疗关节软骨缺损的临床应用及有关的实验研究［２，３，５?In order to observe the procees of repairing articular cartilage defect and compare the effect of repairing after subchondral drilling with different diameter of hole,full-thickness defects of 6mm×8mm were created over the articular surface of both the femoral condyles in 24 rabbits.The hole of the 1mm and 1.5mm were drilled respectively over the defects.They were sacrificed postoperatively at the end of 4 and 8 weeks.The newly formed tissue in the defects were examined histologically and ultrastructurally.The effect of repairing defect in different groups was compared and evaluated.The results as following:Hyalin-like cartilage、immature cartilage or fibrous cartilage was formed respectively in the both groups,and fibrous tissues vvas found ing the controls,The thichness of repair tissues in the 1mm hole was thicker than that of 1.5mm hole(0.1>P>0.05).The covered areas of repair tissue had no significant difference between the 1mm hole and 1.5mm hole groups.It is preliminarily concluded that subchondral bone drilling isfeasible for repairing full-thickness articular cartilage defecta.The repair effect of major hole is superior to that of minor hole.When the defects are not drilled,the tissue regeneration is much less and the repair is insufficient.

关 键 词：类节软骨 软骨缺损 软骨下骨钻孔术 直径 

分 类 号：R681.3[医药卫生—骨科学]