Objective To investigate the effect of homograft of marrow mesenchymal stem cells (MSCs) seeded onto poly-L-lactic acid (PLLA)/gelatin on repair of articular cartilage defects. Methods The MSCs derived from36 Qingzilan rabbits, aging 4 to 6 months and weighed 2.5-3.5 kg were cultured in vitroand seeded onto PLLA/gelatin. The MSCs/ PLLA/gelatin composite was cultured and transplanted into full thickness defects on intercondylar fossa. Thirty-six healthy Qingzilan rabbits were made models of cartilage defects in the intercondylar fossa. These rabbits were divided into 3 groups according to the repair materials with 12 in each group: group A, MSCs and PLLA/gelatin complex(MSCs/ PLLA/gelatin); group B, only PLLA/gelatin; and group C, nothing. At 4,8 and 12 weeks after operation, the gross, histological and immunohistochemical observations were made, and grading scales were evaluated. Results At 12 weeks after transplantation, defect was repaired and the structures of the cartilage surface and normal cartilage was in integrity. The defects in group A were repaired by the hylinelike tissue and defects in groups B and C were repaired by the fibrous tissues. Immunohistochemical staining showed that cells in the zones of repaired tissues were larger in size, arranged columnedly, riched in collagen Ⅱ matrix and integrated satisfactorily with native adjacent cartilages and subchondral bones in group A at 12 weeks postoperatively. In gross score, group A(2.75±0.89) was significantly better than group B (4.88±1.25) and group C (7.38±1.18) 12 weeks afteroperation, showing significant differences (P＜0.05); in histological score, group A (3.88±1.36) was better than group B (8.38±1.06) and group C (13.13±1.96), and group B was better than group C, showing significant differences (P＜0.05). Conclusion Transplantation of mesenchymal stem cells seeded onto PLLA/gelatin is a promising way for the treatment of cartilage defects.
Objective To explore the relationship of the limited resource of the autologous bone marrow mesenchymal stem cells (MSCs) in articularcavity to the treatment results of full-thickness articular cartilage defect, and to investigate whether the extrogenous sodium hyaluronate(SH) promotes the migration of MSCs cultured in vitro tothe articular defect in vivo. Methods Sixty-six Japan rabbits were made the model of the full-thickness articular cartilage defect (5 mm width and 4 mm depth).The autologous MSCs were extracted from the rabbit femur, cultured in vitro, labeledby Brdu, and injected into the injured articular cavity with or without SH. Theexperiment was divided into 4 groups; group A (MSCs and SH, n=15); group B (MSCs, n=15); group C (SH, n=18); and group D (non-treatment, n=18). The morphologic observation was made by HE staining, Mallory staining and immunohistochemical staining after 5 weeks, 8 weeks and 12 weeks of operation. Results There were significant differences in the thickness of repairing tissue between group A and group B(Plt;0.01); but there were no significant differences between group A and group C, and between group B and group D(P＞0.05). Thehistological observation showed that the main repairing tissue was fibrocartilage in group A and fiber tissue in group B. Conclusion MSCs cultured in vitro and injected into the articular cavity can not improve the treatment results of the articular cartilage defect. Extrogenous SH has effect on repairing cartilage defect. The extrogenous SH has no effect on the chemotaxis of the MSCs, and on the collection of MSCs into the joint defect.
Objective To investigate the clinical results of allograft and sural neurovascular flap in repairing calcaneus and skin defects.Methods From February 1996 to December 2002, allograft and sural neurovascular flap were used to repair calcaneusand skin defects in 6 cases. The causes included road accident in 3 cases, strangulation in 2 cases and crashing object in 1 case. The defect locations were at theback of the calcaneus( 1/3, 1/2 and 2/3 of calcaneus in 3 cases, 2 cases and 1case respectively). The flap area ranged from 6 cm×7 cm to 12 cm×17 cm. Results The flaps survived completely in 4 cases; the distal flaps necrosed partly in 2 cases and the wound healed by dressing. The postoperative X-ray films showed that the repaired bone and joint had normal position and the arcus plantaris recovered. After a follow upof 6 months to 3 years all the patients were achieved bone union in allograft and had no complications of absorption, infection and repulsion. The weightbearing and walking functions were restored and the injured foot obtained a satisfactory contour. After 36 months of operation, the sensory recovery of foot occurred. Conclusion The used-allograft iseasy to be obtained and arcus plantaris is easy to recover. The reversesural neurovascular- flap in repairing calcaneus and skin defects has the following advantages: the maintenance of blood supply for injured foot, the less dangerous operation, the simple procedure, the recovery of walking function, and the good appearance and sensation.
OBJECTIVE: To study the effect of platelet-rich plasma in the repair of bone defect. METHODS: Segmental bone defects of 1 cm were created in the mid-upper part of bilateral radius of 24 New Zealand white rabbits. One side was randomly chosen as the experimental side, which was filled with artificial bone with platelet-rich plasma (PRP). The other side filled with artificial bone without PRP as the control. After 2, 4, 8 and 12 weeks of implantation, the gross, radiological, histological observations, and computer graphic analysis were performed to investigate the bone healing of the defect in both sides. RESULTS: Two weeks after operation, new bone and fibrous tissue formation in both the experimental and the control sides were observed only in the areas adjacent to the cut ends of the host bone, but the amount of new tissue in the experimental side was much more than that in the control side. In the 4th and 8th weeks, the surface of the artificial bone was covered with a large amount of new bones, the artificial bone was bridged tightly with the host bone by callus in the experimental side, while new bone was limited mainly in the cut ends and was less mature in the control side. In the 12th weeks, bone defects were entirely healed in the experimental side, which were covered completely with cortical bone, while new bone formation was only observed in the ends of artificial bone and there were not continuous bone callus on the surface in the control side. CONCLUSION: Artificial bone with PRP is effective in the repair of segmental bone defects, and PRP could improve the healing of bone defect.
Abstract In order to find a new method to repair large bone defect, the free periosteum autograft was investigated in experiment, and then the method was used clinically. In the experiment, a 6mm×18mm×5mm bone defect was made at upper end of both tibiae of 42 rabbites. The periosteum of each rabbit was cut into 1mm cubes, and implanted randomly into the tbial bone defect on one side and the other side was used as control. After 2, 4, 8 weeks, the bone defects of each group were examined for bone formation by roentgenography, radionuclide and histology. The results showed that the defects treated by free periosteum autografts healed twice as fast as the controls (its natural healing). The reason probably was that the periosteum provided with many osteogenic cells. On thebasis of these results, 21 cases of bone defects (the largest was 10.5cm×4cm×4cm, the smallest was 2cm×2cm×2cm) including 17 cases of benign bone tumor and4 cases of chronic osteomyelitis, were treated by free periosteum autografts. The defects were all healed, and the function of the joints was restored.
Chitin was used as the stuffing material bonedefect in animal experiment. Radiological and his-tological examination showed that it had good bi-ologgical compatibility good strength, hemostaticeffect promoting tussue healing and no toxicity.Chitin could be degradated by enzyme and mightbe used as the bone supporting material for treament of bone defect.
Abstract An experiment was carried out to investigate the possibility of the establishment of an osteoblasts bank which could supply osteoblasts in repairing bone defect. Osteoblasts were isolated from thetibial periosteum of eight New-Zealand rabbits and cultured in votro. A bone defect, 1.5cm in length was made in both radii of each of the 8 rabbits. The cultivated osteoblasts, gelfoam as a carrier were randomly implanted into the defects of the radii of rabbits. Accordingly, the contralateral radial defects wereimplanted with gelfoam absorbed with the Hanks solution as control. The healing of bone defects was evaluated by roentgenographic examination at 2, 4, 8 and 12 weeks after operation, respectively. It was shown that the implanted cells had osteogenetic capability and could be possible to promote healing of the bone defects. It was suggested that further study needed to be carried out in this field.
Objective To investigate the clinical application of self-cranial bone powder in one stage cranioplasty．Methods From October 1999 to December 2002,self-cranial bone powder and medical adhesive were used to repair the skull defect, for one stage cranioplasty, caused by operations on cranium in 128 casesof severe dangerous craniocerebral injury, acute intracranial hematome, sick skull and intracranial tumor．The bone growth was observed by CT or X-ray examination 3-24 months after replantation of cranioplasty．Results The decompression and cranioplasty were performed simultaneously, the time prolonged 5-10 minutes than that of routine, the appearance of repaired cranial bone was normal, without concavity and convexity. After 12 months of operation, the replanted bone merged with the normal bone completely, with normal appearance. The operation successful rate was 96.1%(123/125) without any complication. Only fivecases were not better in growing because of less bone powder, but withoutcerebral pulse and defective syndrome. All the cases did not need secondary cranioplasty．Conclusion The effect of cranioplasty with self-cranial bone powder effect is good in taking shape. This new method can avoid the traditional secondary cranioplasty for skull defect and complications．
Objective To study the effect of autogenous bone marrow on guided bone regeneration (GBR),and evaluate the repairing ability of GBR in bone defect with autogenous bone marrow. Methods Ten mm segmental defects were produced in both radii of 18 rabbits. The defect was bridged with a silicon tube. Autogenous bone marrow was injected into the tube on the experimental group at 0, 2,4 weeks after operation, and peripheralblood into the control group at thesame time. The X-ray, gross, histological and biochemical examinations were observed invarious times. Results The new bone formation of experimental group was prior to that of control group; calcium and alkaline phosphatase of experimental groupwere higher than those of control group. The experimental group had all been healed at the tenth week, but no one healed in control group. Conclusion It can be conclude that autogenous bone marrow can stimulate bone formation and facilitate GBR in bone defect.
Abstract In order to repair the bone defect afteroperation of benign lesion of extremity, the fetal demineralized bone was applied in 10 cases. These cases were followed up for 6 months to 8 years. The results showed that the grafted bone was integrated with the host bone in 6 months. Noadverse effect was found. The demineralized bone did not induce rejection. The advantages of using fetal demineralized bone were as follows: easily obtainable,its preparation and method of storage simple, and low finacial cast.