双相PLGA支架结合BMSCs修复兔膝关节骨软骨缺损的实验研究  

Experimental study on the repair of osteochondral defects of rabbit knee joints with biphasic PLGA scaffold combined with BMSCs

作　　者：余敏[1] 丑克[1] 李雨佳[2] Yu Min;Chou Ke;Li Yujia(Orthopedics Department(Department of Sports Medicine and Joint Surgery),Changsha Central Hospital,Changsha 410004,Hunan,China;Department of Orthopedics,the Second Xiangya Hospital,Central South University,Changsha 410011,Hunan,China)

机构地区：[1]长沙市中心医院骨科(运动医疗、关节外科),湖南长沙410004 [2]中南大学湘雅二医院骨科,湖南长沙410011

出　　处：《中国现代手术学杂志》2023年第1期1-7,共7页Chinese Journal of Modern Operative Surgery

基　　金：长沙市2020年度指导性科技计划项目(kzd2001065)。

摘　　要：目的研究双相聚乳酸聚乙醇酸共聚物(poly lactic-co-glycolic acid,PLGA)支架结合骨髓间充质干细胞(bone marrow stromal cells,BMSCs)修复兔膝关节骨软骨缺损的效果。方法对20只健康新西兰大白兔的40个膝关节股骨滑车部位戳孔,造成直径5 mm深4~5 mm的骨软骨缺损,并随机分为实验组和空白组,每组各20个膝关节。实验组植入PLGA支架与BMSCs的复合物;空白组采取自发修复,不植入任何材料。术后6周、12周分批处死,比较两组改良Cook评分和国际软骨修复协会软骨修复组织(International Cartilage Repair Society,ICRS)评分;比较实验组修复12周后的膝关节标本和正常关节标本的生物力学参数。结果术后6周,实验组和空白组的改良Cook评分为8.1±0.4 vs.4.3±0.9,ICRS评分为12.4±0.9 vs.0.8±0.2;术后12周,实验组和空白组的改良Cook评分为9.2±0.3 vs.5.2±1.2,ICRS评分为17.2±0.3 vs.3.7±0.5。两组比较均有统计学差异(P=0.000)。实验组修复12周后的膝关节标本和正常关节标本的生物力学比较,蠕变时间为(2314±592)s vs.(2763±649)s,应力松弛时间为(1936±334)s vs.(2142±402)s,杨氏模量为(0.32±0.13)MPa vs.(0.36±0.22)MPa,差异均无统计学意义(P>0.05)。结论双相PLGA支架结合BMSCs修复兔膝关节软骨及软骨下骨缺损效果理想,修复后各项生物学特性接近正常关节组织。Objective To investigate the repair effect of osteochondral defect with biphasic poly lactic-co-glycolic acid(PLGA)scaffold combined with bone marrow stromal cells(BMSCs).Methods 40 healthy New Zealand white rabbits were punctured at the femoral trochlear area of their knee joints,resulting in osteochondral defects with a diameter of 5mm and a depth of 4~5mm.They were randomly divided into an experimental group and a blank group,with 20 knee joints in each.The experimental group was implanted with a composite of PLGA scaffold and BMSCs.The blank group received spontaneous repair without implantation of any materials.After 6 and 12 weeks of surgery,the rabbits were euthanized in batches,and the modified Cook score and the International Cartilage Repair Society(ICRS)score were compared between the two groups.The biomechanical parameters were compared between the knee joint specimens of the experimental group after 12 weeks of repair and normal joint specimens.Results Six weeks after surgery,the modified Cook score of the experimental group and blank group was 8.1±0.4 vs.4.3±0.9,and the ICRS score was 12.4±0.9 vs.0.8±0.2.Twelve weeks after surgery,the modified Cook score of the experimental group and the blank group was 9.2±0.3 vs.5.2±1.2,and the ICRS score was 17.2±0.3 vs.3.7±0.5.There were statistical differences between the two groups in the modified Cook score and the ICRS score(P=0.000).Comparing the biomechanical properties of knee joint specimens of the experimental group after 12 weeks of repair and normal joint specimens,the creep time was(2314±592)s.vs.(2763±649)s.Stress relaxation time was(1936±334)s vs.(2142±402)s.The Young's modulus was(0.32±0.13)MPa vs.(0.36±0.22)MPa.And the differences were not statistically significant(P>0.05).Conclusion The biphasic PLGA scaffold combined with BMSCs has an ideal effect on repairing cartilage and subchondral bone defects in the rabbit knee joint,and the biological characteristics after repair are close to normal.

关 键 词：聚乳酸聚乙醇酸共聚物 双相支架 骨软骨缺损 

分 类 号：R318.08[医药卫生—生物医学工程]