Effect of low-energy shock waves in microfracture holes in the repair of articular cartilage defects in a rabbit model
Effect of low-energy shock waves in microfracture holes in the repair of articular cartilage defects in a rabbit model
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DOI：
10.3760/cma.j.issn.0366-6999.2011.09.021
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发表时间：
2011-05-05
影响因子：
6.1
通讯作者：
Zhu Juan-li
中科院分区：
文献类型：
--
作者：
Wang Qi;Li Zhong-li;Zhu Juan-li
背景微骨折是关节镜下软骨修复中的一种骨髓刺激。然而，间充质干细胞的总体浓度相当低，并随着年龄的增长而下降，最终病变被纤维软骨填充。本研究的目的是探讨一种新的方法，以提高微骨折，确定是否低能量冲击波在微骨折孔将促进软骨修复在兔model.Methods全层软骨缺损的36只成熟的新西兰白色兔的股骨内侧髁没有穿透软骨下骨。将家兔随机分为3组。在实验组A中，通过DolorClast Master（Electro Medical Systems SA，Switzerland）微探针（直径，0.8 mm）在微骨折孔（直径，1 mm）中进行低能冲击波治疗，能量通量密度（EFD）为0.095 mJ/mm（2），脉冲次数为200次。实验组B单纯行微骨折术。未处理的家兔作为对照组。结果实验组A、B缺损逐渐被修复组织填充，对照组12周时未见修复组织形成。实验组A的修复组织中含有更多的软骨细胞、蛋白多糖和II型胶原，而实验组B的修复组织中含有更多的软骨细胞、蛋白多糖和II型胶原。实验组B在8周和12周时缺损处已形成纤维组织。组织学分析显示实验A组Wakitani评分较好（P
Background Microfracture is a type of bone marrow stimulation in arthroscopic cartilage repair. However, the overall concentration of the mesenchymal stem cells is quite low and declines with age, and in the end the lesion is filled by fibrocartilage. The aim of this research was to investigate a novel method of enhancing microfracture by determining whether low-energy shock waves in microfracture holes would facilitate cartilage repair in a rabbit model.Methods Full-thickness cartilage defects were created at the medial femoral condyle of 36 mature New Zealand white rabbits without penetrating subchondral bone. The rabbits were randomly divided into three groups. In experimental group A, low-energy shock-wave therapy was performed in microfracture holes (diameter, 1 mm) at an energy flux density (EFD) of 0.095 mJ/mm(2) and 200 impulses by DolorClast Master (Electro Medical Systems SA, Switzerland) microprobe (diameter, 0.8 mm). In experimental group B, microfracture was performed alone. The untreated rabbits served as a control group. At 4, 8, and 12 weeks after the operations, repair tissues at the defects were analyzed stereologically, histologically, and immunohistochemically.Results The defects were filled gradually with repair tissues in experimental groups A and B, and no repair tissues had formed in the control group at 12 weeks. Repair tissues in experimental group A contained more chondrocytes, proteoglycans, and collagen type II than those in experimental group B. In experimental group B, fibrous tissues had formed at the defects at 8 and 12 weeks. Histological analysis of experimental group A showed a better Wakitani score (P