新型骨软骨支架辅助Mosaicplasty技术和携带增强基因的ADSCs对大面积骨软骨缺损的修复效果  

Effect of new osteochondral scaffold-assisted Mosaicplasty technology genetically enhanced ADSCs on repair of large area osteochondral defect

作　　者：阮世强[1] 邓江[1] 徐林[1] 黄文良[1] 田仁元 

机构地区：[1]贵州省遵义市第一人民医院骨科,贵州遵义563003

出　　处：《中国现代医学杂志》2017年第30期8-14,共7页China Journal of Modern Medicine

基　　金：贵州省科学技术项目(No:[2016]1420);国家自然科学基金(No:81660367)

摘　　要：目的考察新型骨软骨支架辅助Mosaicplasty技术和携带增强基因的脂肪间充质干细胞(ADSCs)对大面积骨软骨缺损修复效果。方法复制比格犬软骨全层缺损模型,使用多枚骨软骨支架以Mosaicplasty术填充大部分缺损后,不用内固定,作为E组;于骨软骨支架内及残留间隙处缓慢由深至浅注入骨形态发生蛋白2(BMP-2)-ADSCs复合体作为D组;植入丝素蛋白(SF)/壳聚糖(CS)/纳米羟基磷灰石(n HA)支架作为C组;植入SF/CS/n HA支架和BMP-2-ADSCs复合体作为B组;植入SF/CS/n HA支架与BMP-2-ADSCs联合富血小板血浆(PRP)凝胶复合体作为A组。分别于术后4、8及16周各组随机取2、2和4只比格犬在轻度麻醉状态下,进行组织外观观察,处死16周的比格犬,检测病变软骨部位的胶原蛋白Ⅰ和Ⅱ,体外检测病变软骨的极限应力、应变值和相应弹性模量值。结果与E组比,A^D组的软骨缺损表面平整,软骨愈合较好,与B^D组比较,A组恢复最好。膝关节胶原蛋白Ⅰ和胶原蛋白Ⅱ表达、标本中心相应弹性模量值、标本交界极限应力和应变值差异有统计学意义(P<0.05),E组最低,A组最高。结论植入SF/CS/n HA支架与BMP-2-ADSCs联合PRP凝胶复合体对于大面积软骨缺损修复效果较好,值得临床推广。Objective To investigate the effect of new osteochondral scaffold -assisted Mosaicplastytechnology and genetically enhanced adipose-derived stem cells （ADSCs） on repair of large area osteochondraldefect. Methods Beagle dog model of cartilage full-thickness defect was established. The defect was filledwith multiple cartilage scaffolds through Mosaicplasty technology. No fixation was performed in group E. BMP-2-ADSCs was implanted in scaffold in group D. SF/CS/nHA was implanted in scaffold in group C. SF/CS/nHA combined with BMP-2-ADSCs was implanted in scaffold in group B. SF/CS/NHA and BMP-2-ADSCscombined with PRP gel complex was implanted in scaffold in group A. Morphological changes of tissue wereobserved at the 4th, 8th, and 16th week post operation, and tissues were harvested at time point of the 16thweek post operation. Collagen Ⅰ and Collagen Ⅱ mRNA were measured by PRC. Ultimate stress, strainvalue and the corresponding elastic modulus of the cartilage were determined. Results Compared with groupE, cartilages in group A-D experienced better healing procedure with improvement of smooth surface. GroupA witnessed dramatically improved cartilages when compared with group B-D （P〈 0.05）. The expression levels of collagen protein Ⅰ and collagen Ⅱ, ultimate stress, strain value and the corresponding elastic moduluswere increased significantly in group A when compared with the remaining groups（P〈 0.05）. Conclusion Newosteochondral scaffold filled with SF/CS/nHA, BMP-2-ADSCs and PRP gel complex through Mosaicplastyatechnology can be therapeutic option for repair of large area cartilage defects.

关 键 词：仿生支架 镶嵌移植术 骨软骨缺损 富血小板血浆 组织工程 

分 类 号：R683[医药卫生—骨科学]