去抗原生物型半月板移植修复羊半月板缺失  

Antigen-free biological meniscus transplantation for repairing meniscus deficiency in goats

作　　者：李晓峰[1] 蔡道章[2] 王昆[2] 

机构地区：[1]南昌大学第一附属医院骨科,江西省南昌市330006 [2]中山大学附属第三医院骨科,广东省广州市510630

出　　处：《中国组织工程研究与临床康复》2009年第50期9837-9841,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:同种异体半月板移植的临床疗效和预后均已获证实,但因来源和匹配问题难以推广。课题组应用已取得专利技术的去抗原处理技术,处理猪的半月板,得到了新型生物型半月板。目的:观察生物型半月板植入山羊膝关节内的组织学变化,探讨生物型半月板重建膝关节半月板的可行性及应用前景。设计、时间及地点:以山羊为对象的动物实验,于2005-06/2006-06在中山大学第三附属医院中心实验室完成。材料:选用健康山羊15只,用于半月板移植实验。取新鲜屠宰的完整猪半月板,用于制备生物型半月板。方法:切除山羊的膝关节内侧半月板,将生物型半月板塑形后原位植入羊的膝关节半月板缺失部位。主要观察指标:分别于术后1,3,6,12个月处死动物,行组织学,扫描电镜及墨汁灌注观察微循环等检测。结果:所有动物患肢切口均愈合良好,无感染,无死亡。植入半月板与周组织愈合良好,连接紧密。随着术后时间的延长,植入半月板逐渐吸收溶解,植入半月板内出现活的细胞,但术后1年仍有约1/4的组织无活细胞。术后1年墨汁灌注发现,周围组织长入并建立微循环,但仅限于周边约10%的范围(正常山羊约15%)。植入半月板在术后6个月开始逐渐吸收溶解,扫描电镜下可见植入半月板表面逐渐毛糙,部分区域有破裂现象,但术后1年仍保持大体的形态。结论:生物型半月板植入山羊体内后,无明显排斥反应,植入半月板能与山羊关节囊良好愈合。植入半月板在溶解吸收过程中,宿主自体组织可以长入并建立微循环,植入半月板对山羊的软骨保护作用明显,但仍观察到轻度的软骨损伤。BACKGROUND： The meniscal allograft transplantation has been proved good outcome in clinical, however, the source and matching restrict its application. By means of a patent technique of separating antigen, a new biological meniscus can be obtained. OBJECTIVE： To observe the histological changes of transplanted biological meniscus in goat＇s knee joint, in addition, to investigate the feasibility of reconstituting meniscus by using biological meniscus. DESIGN, TIME AND SETTING： The animal experiment of goats was performed at the Central Laboratory in the Third Affiliated Hospital of Sun Yat-sen University between June 2005 and June 2006. MATEAIALS： A total of 15 healthy goats were used in the experiment. Fresh porcine meniscus was harvested for the preparing of biological meniscus. METHODS： The medial meniscus of goat was excised, and then the absent part was repaired using biological meniscus. MAIN OUTCOME MEASURES： The animals were sacrificed at months 1, 3, 6 and 12 after operation. And the samples were detected by histology, scanning electron microscopy （SEM） and Indian ink perfusion. RESULTS： The incision of all animals healed well, without infection or death. The transplanted meniscus healed well with the surrounding tissue, and the connection was tight. With time prolonged, the transplanted meniscus slowly soaked, and live cells existed inside the meniscus, but there were no live cells in about 1/4 district at 1 year after the surgery. Indian ink perfusion showed that the surrounding tissue grew inside and set up microcirculation, but only limited to 10% periphery of the meniscus （normal goat approximately 15%）. The transplanted meniscus began the necrosis at 6 months after surgery. Under SEM, the surface of the meniscus became crude and cracked in some places, but still maintains the gross shape at 1 year after the surgery. CONCLUSION： There is no obvious rejection after the biological meniscus was transplanted into knee joint of goats. During the process of absorption, autologous

关 键 词：生物型 半月板 羊 膝关节 

分 类 号：R318[医药卫生—生物医学工程]