Chondral defect repair after the microfracture procedure - A nonhuman primate model
Chondral defect repair after the microfracture procedure - A nonhuman primate model
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DOI：
10.1177/0363546504271744
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发表时间：
2005-05-01
影响因子：
4.8
通讯作者：
Morris, EA
中科院分区：
文献类型：
--
作者：
Gill, TJ;McCulloch, PC;Morris, EA
背景：人类微骨折后软骨缺损愈合的程度和时间过程还没有很好的描述。虽然大多数医生建议一段时间的活动和负重限制，以保护愈合的软骨，有有限的数据，根据决定关于这种限制的持续时间。假设：在灵长类动物模型中，在微骨折后不同时间点的软骨缺损修复状态的评价可能为术后活动建议提供一个理论基础。12只食蟹猴的股骨髁和trophila上创建的全层软骨缺损与微骨折治疗，并在6周和12周进行大体和组织学检查进行评价。结果：在6周时，有有限的软骨修复和持续吸收的软骨下骨。结论：在灵长类动物模型中，在微骨折后6- 12周的时间点，观察到软骨修复的程度和质量的显著改善。临床相关性：第6周时缺损修复的不良状态以及从6- 12周时间点观察到的持续愈合可能表明在术后初期修复是脆弱的。假设微骨折患者术后负重和活动限制的目的是保护未成熟的修复组织，本研究支持将此类建议延长至6周以上。
Background: The extent and time course of chondral defect healing after microfracture in humans are not well described. Although most physicians recommend a period of activity and weightbearing restriction to protect the healing cartilage, there are limited data on which to base decisions regarding the duration of such restrictions.Hypothesis: Evaluation of the status of chondral defect repair at different time points after microfracture in a primate model may provide a rationale for postoperative activity recommendations.Study Design: Descriptive laboratory study.Methods: Full-thickness chondral defects created on the femoral condyles and trochlea of 12 cynomolgus macaques were treated with microfracture and evaluated by gross and histologic examination at 6 and 12 weeks.Results: At 6 weeks, there was limited chondral repair and ongoing resorption of subchondral bone. By 12 weeks, the defects were completely filled and showed more mature cartilage and bone repair.Conclusion: In the primate animal model, significant improvements in the extent and quality of cartilage repair were observed from the 6- to 12-week time points after microfracture.Clinical Relevance: The poor status of the defect repair at 6 weeks and the ongoing healing observed from the 6- to 12-week time points may indicate that the repair is vulnerable during this initial postoperative period. Assuming the goal of postoperative weightbearing and activity restriction in patients after microfracture is to protect immature repair tissue, this study lends support to extending such recommendations longer than 6 weeks.