Delamination rates of tissue flaps used in articular cartilage repair
Delamination rates of tissue flaps used in articular cartilage repair
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DOI：
10.1002/jor.1100180609
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发表时间：
2000-11-01
影响因子：
2.8
通讯作者：
Hunziker, EB
中科院分区：
文献类型：
--
作者：
Driesang, IMK;Hunziker, EB
治疗关节软骨损伤的一种流行策略是将细胞悬浮液引入缺损空隙中，并用骨膜绒毛同体软骨细胞移植技术将其封闭。我们在山羊身上应用了这种方法，发现所有缝合的皮瓣（n = 6 只动物）在恢复期间都与非固定关节分离。本研究的目的是确定术后限制关节运动是否可以防止皮瓣分层。在 27 只山羊的膝关节软骨中产生了部分厚度的缺损。然后用纤维蛋白基质填充这些缺损，并用骨膜（n = 6）或筋膜（n = 21）皮瓣覆盖，用简单的间断缝线将其缝合到周围组织。使用改良的罗伯特·琼斯绷带将关节固定 2-6 周，之后检查是否有皮瓣。在四只动物中，关节固定三周，然后在相似的时间内自由活动。固定期后，六个骨膜瓣中的四个和 21 个筋膜瓣中的两个发生分层。在四只山羊中，在相似的关节固定期后允许进行 3 周的自由关节运动，所有皮瓣（一直保留到固定期结束）都脱落。这些发现表明，关节固定阻碍了皮瓣的分层，但这种运动限制必须持续一段不确定的时间。用于皮瓣的组织的性质也影响其通过固定关节的保留率。
A popular strategy in the treatment of articular cartilage lesions involves the introduction of cell suspensions into the defect void and its closure with a periosteal nap tautologous chondrocyte transplantation technique). We applied this methodology in goats and discovered that all sutured flaps (n = 6 animals) became detached from nonimmobilized joints during the recovery period. The purpose of this study was to ascertain whether postoperative restriction of joint movement could prevent the delamination of flaps. Partial-thickness defects were created in the knee joint cartilage of 27 goats. These defects were then filled with a fibrin matrix and covered with periosteal (n = 6) or fascial (n = 21) flaps, which were sutured with simple, interrupted stitches to the surrounding tissue. The joints were immobilized by means of a modified Robert Jones bandage for periods of 2-6 weeks, after which time they were inspected for the absence or presence of flaps. In four animals, joint immobilization for 3 weeks was followed by free movement for a similar period. Four of the six periosteal flaps and two of the 21 fascial ones became delaminated after the period of immobilization. In the four goats permitted 3 weeks of free joint movement following a similar period of joint immobilization, all flaps (which had been retained up to the end of the immobilization period) became detached. These findings indicate that joint immobilization hinders the delamination of flaps but that this restriction of movement must be sustained for an undefined period of time. The nature of the tissue used for flaps also influences their rate of retention by immobilized joints.