Development of a novel surgical procedure for large osteochondral defects using platelet rich plasma(PRP)

本研究的目的是利用多孔羟基磷灰石（HA），包括富血小板血浆（PRP）来源的纤维蛋白凝胶和海藻酸盐回收软骨细胞法（ARC法）产生的无支架软骨组织，开发一种治疗关节内骨软骨缺损的新手术技术。首先，我们检测了prp来源的纤维蛋白凝胶对培养兔软骨细胞代谢的影响。我们还研究了ARC组织在体内多孔透明质酸块上的成熟过程。在此基础上，我们将含PRP（或血小板缺乏血浆，PPP）和ARC组织的HA块植入大骨软骨缺损，并观察这一过程对骨和软骨组织修复的影响。在PRP纤维蛋白凝胶上三维培养关节软骨细胞（包埋在海藻酸珠中），促进了关节软骨细胞的增殖和海藻酸珠中总蛋白多糖（PG）的含量，而PRP凝胶则显著降低了海藻酸珠中总蛋白多糖（PG）的含量。将ARC组织置于多孔HA块上，植入胸腺裸小鼠皮下袋内，组织与Hablock表面融合良好。在这种情况下，在8周内观察到ARC组织成熟。将HA-ARC组织构建体与PRP凝胶植入骨软骨缺损，促进软骨修复和骨形成。这些结果表明PRP凝胶联合HA-ARC植入可以作为修复大骨软骨病变的有效方法。

The purpose of this study was to develop a new surgical technique for intra-articular osteochondral defects using porous hydroxyapatite (HA) including platelet rich plasma (PRP)-derived fibrin gel and scaffold-free cartilage tissue produced by the alginate-recovered-chondrocyte method (ARC method). First of all, we examined the effects of PRP-derived fibrin gel on the metabolism of cultured rabbit chondrocytes. The maturation process of the ARC tissue on porous HA block in vivo was also investigated. On the basis of these results, we implanted HA blocks with PRP (or platelet poor plasma, PPP) and the ARC tissue into the large osteochondral defects, and examined the effects of this procedure on bone and cartilage tissue repair. Three-dimensional cultivation of articular chondrocytes (embedded in alginate beads) on PRP-derived fibrin gel promoted their proliferation and total proteoglycan (PG) content in alginate bead, while PG content normalized with DNA content in alginate bead was significantly decreased by PRP gel When the ARC tissue was placed on porous HA block and implanted into subcutaneous pocket of athyrnir nude mice, the tissue was well integrated with the surface of Hablock. Maturation of the ARC tissue was observed in this condition within 8 weeks. Implantation of the HA-ARC tissue constructs with PRP gel into osteochondral defects enhanced cartilage repair and bone formation. These results suggest that combination of PRP gel with HA-ARC implantation can be a useful procedure for the repair of large osteochondral lesions.