Adipose-Derived Stem Cell Sheets Improve Early Biomechanical Graft Strength in Rabbits After Anterior Cruciate Ligament Reconstruction
Adipose-Derived Stem Cell Sheets Improve Early Biomechanical Graft Strength in Rabbits After Anterior Cruciate Ligament Reconstruction
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DOI：
10.1177/03635465211041582
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发表时间：
2021-10
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影响因子：
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通讯作者：
Tatsuaki Matsumoto;Yuiko Sato;Tami Kobayashi;Kunika Suzuki;Atsushi Kimura;T. Soma;Eri Ito;Toshiyuki Kikuchi;S. Kobayashi;K. Harato;Y. Niki;M. Matsumoto;M. Nakamura;T. Miyamoto
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文献类型：
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作者：
Tatsuaki Matsumoto;Yuiko Sato;Tami Kobayashi;Kunika Suzuki;Atsushi Kimura;T. Soma;Eri Ito;Toshiyuki Kikuchi;S. Kobayashi;K. Harato;Y. Niki;M. Matsumoto;M. Nakamura;T. Miyamoto
工作背景：虽然各种重建技术可用于前交叉韧带（ACL）损伤，但患者恢复体育活动之前需要较长的恢复时间，因为重建的ACL需要时间来恢复强度。迄今为止，已有几项研究报道了间充质干细胞在骨科手术中的应用;然而，尚无研究在ACL重建（ACLR）中使用脂肪干细胞（ADSC）片。假设：ADSC片移植可提高ACLR中自体移植物的生物力学强度。研究设计：对照实验室研究。研究方法：将68只健康日本白色家兔随机分为对照组（无铺片; n = 34）和铺片组（ADSC铺片; n = 34），进行单侧自体半腱肌腱移植ACLR。分别于术后2、4、8、16、24周处死各组兔，采用组织学染色、显微计算机断层扫描和生物力学测试评价腱-骨愈合情况。在24周时，对移植物中间体进行扫描透射电子显微镜检查。结果如下：对照组和片材组的极限失效载荷分别如下：17.2 ± 5.5与37.3 ± 10.3（P =.01）2周时，28.6 ± 1.9 vs 47.4 ± 10.4（P =.003）第4周时，53.0 ± 14.3 vs 48.1 ± 9.3（P =.59），16周时为66.2 ± 9.3与95.2 ± 43.1（P =.24），24周时为66.7 ± 27.3与85.3 ± 29.5（P =.39）。在长达8周的早期阶段，片材组的组织学评分也显著高于对照组。在显微计算机断层扫描上，相对于对照组，4周时片材组的骨隧道面积显著更窄，24周时肌腱-骨界面的骨体积/组织体积显著更大。在24周的扫描透射电子显微镜检查表明，平均胶原纤维直径的中间物质是显着更大的，因为是每个视野的胶原纤维的占有率，在片组。结论：ADSC片材在体内兔模型中改善生物力学强度，防止骨隧道扩大，并促进肌腱-骨界面愈合和移植物中间体愈合。临床相关性：ADSC片可能有助于ACLR的早期肌腱-骨愈合和移植物成熟。
Background: Although various reconstruction techniques are available for anterior cruciate ligament (ACL) injuries, a long recovery time is required before patients return to sports activities, as the reconstructed ACL requires time to regain strength. To date, several studies have reported use of mesenchymal stem cells in orthopaedic surgery; however, no studies have used adipose-derived stem cell (ADSC) sheets in ACL reconstruction (ACLR). Hypothesis: ADSC sheet transplantation can improve biomechanical strength of the autograft used in ACLR. Study Design: Controlled laboratory study. Methods: A total of 68 healthy Japanese white rabbits underwent unilateral ACLR with a semitendinosus tendon autograft after random enrollment into a control group (no sheet; n = 34) and a sheet group (ADSC sheet; n = 34). At 2, 4, 8, 16, and 24 weeks after surgery, rabbits in each group were sacrificed to evaluate tendon-bone healing using histological staining, micro–computed tomography, and biomechanical testing. At 24 weeks, scanning transmission electron microscopy of the graft midsubstance was performed. Results: The ultimate failure load for the control and sheet groups, respectively, was as follows: 17.2 ± 5.5 versus 37.3 ± 10.3 (P = .01) at 2 weeks, 28.6 ± 1.9 versus 47.4 ± 10.4 (P = .003) at 4 weeks, 53.0 ± 14.3 versus 48.1 ± 9.3 (P = .59) at 8 weeks, 66.2 ± 9.3 versus 95.2 ± 43.1 (P = .24) at 16 weeks, and 66.7 ± 27.3 versus 85.3 ± 29.5 (P = .39) at 24 weeks. The histological score was also significantly higher in the sheet group compared with the control group at early stages up to 8 weeks. On micro–computed tomography, relative to the control group, the bone tunnel area was significantly narrower in the sheet group at 4 weeks, and the bone volume/tissue volume of the tendon-bone interface was significantly greater at 24 weeks. Scanning transmission electron microscopy at 24 weeks indicated that the mean collagen fiber diameter in the midsubstance was significantly greater, as was the occupation ratio of collagen fibers per field of view, in the sheet group. Conclusion: ADSC sheets improved biomechanical strength, prevented bone tunnel enlargement, and promoted tendon-bone interface healing and graft midsubstance healing in an in vivo rabbit model. Clinical Relevance: ADSC sheets may be useful for early tendon-bone healing and graft maturation in ACLR.