不同孔径钻孔术对兔关节软骨缺损修复的影响  

Influence of Drilling with Different Diameter of Holes on the Repair of Articular Cartilage Defect in Rabbits

作　　者：葛志强[1,2] 冯传汉[1,2] 吕厚山 曲月波[1,2] 杨洪峰 雷学锋[1,2] 曹化祥 廉平[1,2] 祝海洲 李咸洲[1,2] 

机构地区：[1]济宁医学院外科教研室 [2]北京医科大学人民医院骨科

出　　处：《中华创伤杂志》1997年第2期93-95,共3页Chinese Journal of Trauma

基　　金：美国中华医学基金会

摘　　要：目的：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．方法：用中国白兔２４只，在股骨关节面造成６ｍｍ×８ｍｍ全层软骨缺损，分别施行孔径１ｍｍ和１．５ｍｍ的钻孔术，术后４、８周取材，行组织学，光、电镜检查并进行评估．结果：（１）两组的优势修复组织均混有类透明软骨、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孔厚．（３）修复组织覆盖缺损的面积，两组间无显著性差异．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较差．Aim: To observe the process of repairing articular cartilage defect and compare the effect of repairing after subchondral drilling with different diameter of holes. Methods: Full thickness defects of 6mm × 8mm were created over the articular surface of both the femoral condyles in 24 rabbits. The holes of 1mm and 1.5mm were drilled respectively over the defects with the exception of those of the control ones. They were sacrificed postoperatively at the end of 4 and 8 weeks. The newly formed tissues in the defects were examined histologically and ultrastructurally. The effect of the repair defect in different groups was compared and evaluated. Results: 1. Hyalin like cartilage, immature cartilage of fibrous cartilage were formed respectively in both groups, and fibrous tissues were found in the controls. 2. The thickness of repair tissues in the 1 mm hole was thicker than that of 1.5 mm ones (0.1> P >0.05). 3. The covered areas of repair tissue had no significant difference between the 1 mm hole and the 1.5mm hole groups. Conclusion: We consider that subchondral bone drilling is feasible for repairing full thickness articular cartilage defects. 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 insufficient.

关 键 词：关节软骨缺损 钻孔术 修复术 

分 类 号：R684.05[医药卫生—骨科学] R687.3[医药卫生—外科学]