Implantation of Autogenous Meniscal Fragments Wrapped With a Fascia Sheath Enhances Fibrocartilage Regeneration In Vivo in a Large Harvest Site Defect
Implantation of Autogenous Meniscal Fragments Wrapped With a Fascia Sheath Enhances Fibrocartilage Regeneration In Vivo in a Large Harvest Site Defect
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DOI：
10.1177/0363546509350749
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发表时间：
2010-04-01
影响因子：
4.8
通讯作者：
Tohyama, Harukazu
中科院分区：
文献类型：
--
作者：
Kobayashi, Yasukazu;Yasuda, Kazunori;Tohyama, Harukazu
背景：关于半月板组织再生，许多研究人员对组织工程半月板的发展进行了研究。假设：自体半月板碎片包覆筋膜鞘植入供区半月板缺损区可显著促进体内纤维软骨的再生。研究设计：对照实验室研究。方法：本研究选用75只成年兔。每只动物的右侧内侧半月板的前三分之一被切除。然后将动物分为3组，每组25只：第1组，半月板缺损处不做任何处理。第2组用筋膜鞘覆盖创面。第3组，将切除的半月板粉碎成小块后，植入缺损区。然后，半月板断裂的缺损处用筋膜鞘覆盖。每组各5只于术后3、6、12周取材进行组织学评价，5只于术后6周、12周取材进行生物力学评价。结果：组织学观察，3组大圆细胞散在分布于半月板状组织的核心部，12周时这些细胞周围的基质呈藏红花O和甲苯蓝染色阳性。3组的组织学评分明显高于1组和2组。生物力学方面，3组的最大载荷和最大刚度明显大于1组和2组。结论：本研究清楚地表明，在兔半月板切除后12周，自体半月板碎片包裹筋膜鞘的半月板移植到供区半月板缺损处，显著促进了体内纤维软骨的再生。
Background: Concerning meniscal tissue regeneration, many investigators have studied the development of a tissue-engineered meniscus. However, the utility still remains unknown.Hypothesis: Implantation of autogenous meniscal fragments wrapped with a fascia sheath into the donor site meniscal defect may significantly enhance fibrocartilage regeneration in vivo in the defect.Study Design: Controlled laboratory study.Methods: Seventy-five mature rabbits were used in this study. In each animal, an anterior one-third of the right medial meniscus was resected. Then, the animals were divided into the following 3 groups of 25 rabbits each: In group 1, no treatment was applied to the meniscal defect. In group 2, the defect was covered with a fascia sheath. In group 3, after the resected meniscus was fragmented into small pieces, the fragments were grafted into the defect. Then, the defect with the meniscal fragments was covered with a fascia sheath. In each group, 5 rabbits were used for histological evaluation at 3, 6, and 12 weeks after surgery, and 5 rabbits were used for biomechanical evaluation at 6 and 12 weeks after surgery.Results: Histologically, large round cells in group 3 were scattered in the core portion of the meniscus-shaped tissue, and the matrix around these cells was positively stained by safranin O and toluisin blue at 12 weeks. The histological score of group 3 was significantly higher than that of group 1 and group 2. Biomechanically, the maximal load and stiffness of group 3 were significantly greater than those of groups 1 and 2.Conclusion: This study clearly demonstrated that implantation of autogenous meniscal fragments wrapped with a fascia sheath into the donor site meniscal defect significantly enhanced fibrocartilage regeneration in vivo in the defect at 12 weeks after implantation in the rabbit.Clinical relevance: This study proposed a novel strategy to treat a large defect after a meniscectomy.