hIGF-Ⅰ基因增强Mosaicplasty技术重建膝负重区大面积骨软骨复合缺损实验研究  

Reconstruct large osteochondral defects of weight-bearing area by hIGF-I gene enhanced Mosaicplasty technique

作　　者：张洁[1] 黄辉[2] 姜翠萍 孙一[4] 李晓飞[4] 张海宁[4] 王英振[4] Zhang Jie;Huang Hui;Jiang cuiping;Sun Yi;Li Xiaofei;Zhang Haining;Wang Yingzhen(Department of Endocrinology,Weifang Traditional Chinese Hosptial,Weifang 261000,China;Department of Anesthesiology,The Affiliated Hospital of Qingdao University,Qingdao 266000,China;Operation room,The Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Joint Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]潍坊市中医院内分泌科,261000 [2]青岛大学附属医院麻醉科,266000 [3]青岛大学附属医院手术室,2660003 [4]青岛大学附属医院关节外科,2660003

出　　处：《中华老年骨科与康复电子杂志》2019年第5期291-296,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金项目资助课题（81672197）

摘　　要：目的研究hIGF-I基因增强组织工程提高Mosaicplasty修复大面积骨软骨缺损的修复质量,改善骨软骨的整合。方法制造山羊膝关节股骨髁大面积骨软骨缺损模型,使用自制Mosaicplasty器械,植入2mm直径骨软骨柱镶嵌充填缺损,以hIGF-I基因转染的骨髓基质干细胞复合可注射藻酸钙凝胶填充残余缺损。同时设立未转染hIGF-I基因的骨髓基质干细胞组、Mosaicplasty组和对照组。术后4w、8w、16w处死动物,行大体观察、光镜、电镜观察,磁共振检查比较修复效果。结果骨软骨缺损在16w时IGF-I基因增强Mosaicplasty组移植物固定牢固,关节面平滑,移植物间界限消失,新生软骨组织类似于正常软骨,4~16w修复效果逐渐改善,优于其他各组。光镜观察见移植的骨软骨生长良好,与新生软骨组织紧密相连,新生的软骨细胞排列规整,细胞外基质分布均一。对照组无明显修复。MRI观察类似大体观察结果。结论使用转染hIGF-I基因的骨髓基质干细胞复合可注射藻酸钙凝胶可促进Mosaicplasty后骨软骨的整合,改善其修复效果。Objective To investigate the outcome of hIGF-I gene enhanced Mosaicplasty to repair large-sized osteochondral compound defects.Methods Osteochondral defects were created on the femoral condyle with the customed Mosaicplasty instruments in a diameter of 6 mm.Osteochondral plugs were harvested around the intercondylar fossa or intertrochlea groove,and pressed into the recipient sites by special instruments in a mosaic mode.hIGF-I gene enhanced tissue engineering was then applied to fill the“dead space”after Mosaicplasty.From 4 to 16 weeks postoperatively,the animals were sacrificed and the specimens were investigated in gross and under electromicroscopy as well as MRI detection.Results The transplanted subchondral bone and superficial cartilage was integrated hardly with each other or with recipient sites in hIGF-I enhanced Mosaicplasty groups.The quality and appearance of the transplanted and regenerated cartilage was similar to normal hyaline cartilage.Under microscopy,the regenerated cartilage was integrated with neighbor tightly in regular arrange.ECM distributed evenly and deeply stained by alcian blue.MRI analysis also demonstrated the healing process between the subchondral bone other than the contrast groups.The effectiveness of the GETE modified Mosaicplasty groups was apparently better than BMSCs modified Mosaicplasty groups and contrast groups.Conclusions hIGF-I gene enhanced tissue engineering can ameliorate the outcome of Mosaicplasty to repair the osteochondral defects in large size.

关 键 词：胰岛素样生长因子 基因 骨软骨 骨软骨镶嵌成形术 

分 类 号：R687.3[医药卫生—骨科学]