Extracellular matrix bioscaffolds for orthopaedic applications - A comparative histologic study
Extracellular matrix bioscaffolds for orthopaedic applications - A comparative histologic study
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DOI：
10.2106/jbjs.e.01008
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发表时间：
2006-12-01
影响因子：
5.3
通讯作者：
Badylak, Stephen F.
中科院分区：
文献类型：
--
作者：
Valentin, Jolene E.;Badylak, John S.;Badylak, Stephen F.
背景：由细胞外基质制备的生物支架材料目前可用于手术修复受损或缺失的肌肉肌腱组织。这些支架在其种类和来源组织、加工方法和最终灭菌方法方面有所不同。本研究的目的是评估五种市售的细胞外基质生物支架在啮齿动物模型中用于骨科软组织修复的宿主组织形态学反应。方法：将126只sd大鼠分为6组，每组21只。在每只动物的腹壁肌肉肌腱组织中制造一个缺陷，然后用五种不同的支架材料（GraftJacket, Restore, CuffPatch, TissueMend, Permacol）中的一种或切除的自体组织进行修复。在术后2、4、7、14、28、56、112天的7个时间点中，每组取3只处死，用组织学和形态学方法对标本进行检查。用半定量方法评估细胞浸润程度、多核巨细胞存在、血管分布和替代结缔组织的组织。结果：在第7天或之后，每一种装置在细胞结构（p < 0.001）、血管分布（p < 0.01）、多核巨细胞的存在（p < 0.01）和重建组织的组织（p < 0.01）方面都引起了不同的形态学反应。更快速降解的设备，如修复和自体组织，细胞浸润量最大，特别是在早期时间点。降解缓慢的器械，如CuffPatch、TissueMend和Permacol，与异物巨细胞的存在、慢性炎症和/或致密、组织不良的纤维组织的积累有关。结论：由细胞外基质组成的生物支架材料会引起不同的宿主组织组织学和形态学反应，这取决于来源物种、来源组织、加工方法和/或最终灭菌方法。临床相关性：细胞外基质装置重塑事件的时间序列，包括支架降解的速度和宿主新组织沉积的程度，可能预测临床过程，并可能决定最佳的康复方案和手术的功能结果。
Background: Biologic scaffold materials prepared from extracellular matrix are currently available for the surgical repair of damaged or missing musculotendinous tissue. These scaffolds differ in their species and tissue of origin, methods of processing, and methods of terminal sterilization. The purpose of the present study was to evaluate the host-tissue morphologic response to five commercially available extracellular matrix-derived biologic scaffolds used for orthopaedic soft-tissue repair in a rodent model.Methods: One hundred twenty-six Sprague-Dawley rats were divided into six groups of twenty-one animals each. A defect was created in the musculotendinous tissue of the abdominal wall of each animal and then was repaired with one of five different scaffold materials (GraftJacket, Restore, CuffPatch, TissueMend, Permacol) or with the excised autologous tissue. Three animals from each group were killed at one of seven time-points after surgery (two, four, seven, fourteen, twenty-eight, fifty-six, and 112 days), and the specimens were examined with histologic and morphologic methods. The degree of cellular infiltration, multinucleated giant cell presence, vascularity, and organization of the replacement connective tissue were evaluated with semiquantitative methods.Results: Each device elicited a distinct morphologic response that differed with respect to cellularity (p < 0.001), vascularity (p < 0.01), the presence of multinucleated giant cells (p < 0.01), and organization of the remodeled tissue (p < 0.01) at or after the Day 7 time-point. More rapidly degraded devices such as Restore and autologous tissue showed the greatest amount of cellular infiltration, especially at the early time-points. Devices that degraded slowly, such as CuffPatch, TissueMend, and Permacol, were associated with the presence of foreign-body giant cells, chronic inflammation, and/or the accumulation of dense, poorly organized fibrous tissue.Conclusions: Biologic scaffold materials composed of extracellular matrix elicit distinct host-tissue histologic and morphologic responses, depending on species of origin, tissue of origin, processing methods, and/or method of terminal sterilization.Clinical Relevance: The temporal sequence of remodeling events of extracellular matrix devices, including the rapidity of scaffold degradation and the extent of new-tissue deposition by the host, may be predictive of the clinical course and may determine the optimal rehabilitation protocol and functional outcome of the procedure.