Prolonged storage effects on the articular cartilage of fresh human osteochondral allografts
Prolonged storage effects on the articular cartilage of fresh human osteochondral allografts
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DOI：
10.2106/00004623-200311000-00008
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发表时间：
2003-11-01
影响因子：
5.3
通讯作者：
Bugbee, WD
中科院分区：
文献类型：
--
作者：
Williams, SK;Amiel, D;Bugbee, WD
背景：新鲜同种异体骨软骨移植是治疗膝关节软骨缺损的成熟技术。人们认为，该技术的基本模式是移植存活的软骨细胞，随着时间的推移保持关节软骨基质。同种异体移植组织通常在供者死亡后42天内移植，但目前尚不清楚保存条件和保存时间如何影响新鲜人类同种异体骨软骨移植物的特性。这项研究检测了保存1、7、14和28天的人同种异体软骨的质量。我们假设软骨细胞活力、软骨细胞代谢活性以及关节软骨的生化和生物力学特性在保存28天后保持不变。方法：在供体死后48小时内，从10个新鲜的人股骨髁取60个骨软骨塞，并将其保存在4℃的培养液中。在收获后1、7、14和28天，通过共聚焦显微镜分析软骨塞的存活率和活细胞密度，(2)通过(SO4)-S-35掺入定量测定蛋白多糖的合成，(3)糖胺多糖含量，(4)压痕硬度，(5)通过静态和动态压缩测试的压缩弹性和水力渗透性，以及(6)通过平衡拉伸测试的拉伸弹性。0.001)。蛋白多糖的合成在7天(p>；0.1)保持不变，然后在14天(p<；0.01)和28天(p<；0.001)下降。在保存28天后，糖胺多糖含量(p>；0.8)、压痕硬度(p>；0.4)、压缩弹性(p>；0.05)、渗透性(p>；0.3)或平衡拉伸弹性系数(p>；0.9)均无显著差异。结论：新鲜同种异体骨软骨组织保存14天以上，细胞存活率、活细胞密度和代谢活性显著降低，同时保持了糖胺聚糖含量和生物力学性能。软骨基质在储存期间被保存28天，但移植后维持基质所需的软骨细胞在这段时间内减少。临床相关性：新鲜的同种异体骨软骨移植得到了很好的建立，并越来越多地被使用，但关于在一段时间内储存过程中发生的组织变化的信息很少。进行新鲜同种异体骨软骨移植的外科医生应该了解长时间储存对移植物质量的影响。
Background: Fresh osteochondral allograft transplantation is a well-established technique for the treatment of cartilage defects of the knee. It is believed that the basic paradigm of the technique is that the transplantation of viable chondrocytes maintains the articular cartilage matrix over time. Allograft tissue is typically transplanted up to forty-two days after the death of the donor, but it is unknown how the conditions and duration of storage affect the properties of fresh human osteochondral allografts. This study examined the quality of human allograft cartilage as a function of storage for a duration of one, seven, fourteen, and twenty-eight days. We hypothesized that chondrocyte viability, chondrocyte metabolic activity, and the biochemical and biomechanical properties of articular cartilage would remain unchanged after storage for twenty-eight days.Methods: Sixty osteochondral plugs were harvested from ten fresh human femoral condyles within forty-eight hours after the death of the donor and were stored in culture medium at 4degreesC. At one, seven, fourteen, and twenty-eight days after harvest, the osteochondral plugs were analyzed for (1) viability and viable cell density by confocal microscopy, (2) proteoglycan synthesis by quantification of (SO4)-S-35 incorporation, (3) glycosaminoglycan content, (4) indentation stiffness, (5) compressive modulus and hydraulic permeability by static and dynamic compression testing, and (6) tensile modulus by equilibrium tensile testing.Results: Chondrocyte viability and viable cell density remained unchanged after storage for seven and fourteen days (p > 0.7) and then declined at twenty-eight days (p < 0.001). Proteoglycan synthesis remained unchanged at seven days (p > 0.1) and then declined at fourteen days (p < 0.01) and twenty-eight days (p < 0.001). No significant differences were detected in glycosaminoglycan content (p > 0.8), indentation stiffness (p > 0.4), compressive modulus (p > 0.05), permeability (p > 0.3), or equilibrium tensile modulus after storage for twenty-eight days (p > 0.9).Conclusions: These data demonstrate that fresh human osteochondral allograft tissue stored for more than fourteen days undergoes significant decreases in chondrocyte viability, viable cell density, and metabolic activity, with preservation of glycosaminoglycan content and biomechanical properties. The cartilage matrix is preserved during storage for twenty-eight days, but the chondrocytes necessary to maintain the matrix after transplantation decreased over that time-period.Clinical Relevance: Fresh osteochondral allografting is well established and increasingly used, but little information is available about the changes in the tissue that occur during storage over a period of time. Surgeons who perform fresh osteochondral allograft transplantation should understand the consequences of prolonged storage on the quality of the graft.