Meniscal rasping for the treatment of the longitudinal tear in the avascular zone of the menisci and transplantation of synovial cells and chondrocytes transinfected with TGF-beta 1

1.我们开发了一种新的手术方法，即刮除半月板表面，以修复无血管区的撕裂。这一过程被证明可以刺激血管对撕裂的诱导，从而导致良好的愈合。为了阐明愈合的机制，在兔双侧内侧半月板前段无血供区制作了一条长5 mm的全层纵向撕裂。然后在左侧半月板的股骨表面上，从膜旁滑膜到包括纵裂在内的内侧，进行约0.5 mm深度的半月板刮除，而右侧半月板不处理作为对照。术后1d、7d、14d、7d，刮削面IL-1α、转化生长因子β1、血小板衍化生长因子、增殖细胞核抗原免疫反应阳性率显著升高。此后，它们的免疫反应性逐渐下降。这些结果提示：1.半月板拉伤可在半月板表面强烈地诱导细胞因子-细胞因子网络，这可能是半月板愈合良好的关键。通过电穿孔转导转化生长因子β1和绿色荧光蛋白(GFP)基因，观察转化生长因子β1基因对胶原包埋的兔滑膜细胞的影响。3周后证实该基因的表达。观察成骨蛋白聚糖和软骨调素的表达。培养上清液中的转化生长因子-β1是对照组的1.4倍。转化生长因子-β1基因转导的滑膜细胞在体外可促进软骨样组织的形成。转导转化生长因子-β1基因的滑膜细胞移植有望成为治疗半月板无血管区撕裂伤的一种新方法。

1. We have developed a new surgical procedure of rasping a meniscal surface in order to repair a tear in the avascular zone. This procedure was demonstrated to stimulate vascular induction to the tear, resulting in good healing. To elucidate the mechanism of the healing, a full thickness-longitudinal tear of 5 mm in length was created in the avascular zone of the anterior segment of both medial menisci of rabbits. Meniscal rasping of about 0.5 mm in depth was then done on the femoral surface of the left meniscus from the parameniscal synovium to the inner portion including the longitudinal tear, while the right meniscus was left untreated as control. In the rasped surface, positive ratio was remarkably increased in immunoreactivity of interleukin-1 α, transforming growth factor β 1, platelet derived growth factor, and proliferating cell nuclear antigen at 1, 7, 14 , and 7 days after surgery, respectively. Thereafter their immunoreactivities gradually declined. These results suggested that meniscal rasping induces strongly the cytokine-cytokine network on the rasped meniscal surface that is likely to be the key to explain the good healing.2. To evaluate the effects of the gene transduction of TGF beta1 on rabbit synovial cells embedded in collagen, TGF-beta1 and green fluorescent protein (GFP) genes were transduced by electroporation. The expression of the gene was confirmed for 3 weeks. Expression of aggrecan and chondromodulin was observed. TGF-beta1 in the culture media was 1.4 times higher than that of control. TGF-beta1 gene transduced synovial cells facilitate the formation of cartilage-like tissue in vitro. Transplantation TGF-beta1 gene transduced synovial cells might be a potential treatment for torn menisci in avascular area.