Treatment of osteochondral defects with autologous bone marrow in a hyaluronan-based delivery vehicle
Treatment of osteochondral defects with autologous bone marrow in a hyaluronan-based delivery vehicle
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DOI：
10.1089/107632702753725085
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发表时间：
2002-04-01
影响因子：
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通讯作者：
Goldberg, VM
中科院分区：
文献类型：
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作者：
Solchaga, LA;Gao, JZ;Goldberg, VM
生物相容性、可生物降解和生物活性材料可以提供结构支撑和分子提示来刺激修复，从而增强骨软骨缺损的自然修复。由于骨髓含有骨软骨祖细胞和生物活性剂，因此推测支架和骨髓的组合将是用于骨软骨修复的优异复合材料。该假设将通过比较用纤连蛋白涂层透明质酸海绵（ACP™）填充（有或没有自体骨髓）的骨软骨缺损的结果来检验。 33 只 4 个月大的兔子接受了直径 3 毫米的骨软骨缺损，然后用负载或未负载自体骨髓的 ACP(TM) 进行填充。手术后 2、3、4、12 和 24 周处死兔子，并对髁突进行组织学和免疫组织化学评估。使用组织学评分标准对缺陷进行分级。除 3 周标本外，两组缺损的组织学外观相似。手术四周后，缺损处被骨头填充，顶层软骨与邻近软骨完美融合。术后12周和24周，缺损再次显示骨填充。 4 周样本与 12 周和 24 周样本之间的主要区别在于软骨层似乎比邻近软骨更薄。在每个收获时间，标本的总体组织学评分没有显示处理组之间的统计差异。然而，正如三周牺牲的结果所揭示的，骨髓负荷似乎加速了修复过程的第一阶段。纤连蛋白涂层的透明质酸支架似乎可以组织自然反应并促进新软骨与邻近组织的整合。从这项研究中得出的基本组织工程原理应该为开发可比较的临床重建疗法提供指导。
The natural repair of osteochondral defects can be enhanced with biocompatible, biodegradable and bioactive materials that provide structural support and molecular cuing to stimulate repair. Since bone marrow contains osteochondral progenitor cells and bioactive agents, it is hypothesized that the combination of scaffold and bone marrow would be a superior composite material for osteochondral repair. This hypothesis will be tested by comparing the outcome of osteochondral defects filled with a fibronectin-coated hyaluronan-based sponge (ACP(TM)) with or without autologous bone marrow. Thirty-three 4-month-old rabbits received 3-mm diameter osteochondral defects that were then filled with ACP(TM) loaded or not with autologous bone marrow. Rabbits were sacrificed at 2, 3, 4, 12, and 24 weeks after surgery and the condyles processed for histologic and immunohistochemical evaluation. The defects were graded with a histologic scoring scale. Except for the 3-week specimens, the histologic appearance of the defects was similar in both groups. Four weeks after surgery, the defects were filled with bone with a top layer of cartilage well integrated with the adjacent cartilage. Twelve and 24 weeks after surgery, the defects again showed bone filling. The primary difference between the 4-week samples and the 12- and 24-week samples was that the layer of cartilage that appeared to be thinner than the adjacent cartilage. At each harvest time, the overall histologic scores of the specimens did not reveal statistical differences between the treatment groups. However, as revealed by the results of the 3-week sacrifices, bone marrow loading appeared to accelerate the first stages of the repair process. The fibronectin-coated hyaluronan-based scaffold appears to organize the natural response and facilitate the integration of the neo-cartilage with the adjacent tissue. The fundamental tissue engineering principles derived from this study should provide guidelines for the development of comparable clinical reconstructive therapies.