In order to observe the histological changes of the autogenous perichondrium graft from rib in the repair of injured articular cartilage of the condylar process of mandible, 50 rabbits were used, in which 15 were served as control. The articular cartilage with its subchondral bone were resected and an autogenous graft of costal perichondrium was sutured onto the raw surface of the condylar process, and in the controls, only the articular portion of the condylar process was resected without the application of autogenous costal perichondrium graft. The morphological changes of the newly formed cartilage during the process of its development were investigated by hiostological and autoradiog aphic techniques. The result revealed that 10 days after operation, the graft had increased in thickness and was richly populated form the proliferation of mesenchyme-like cells. Twenty to thirty days later, the chondrocytes were matured and the newly formed cartilage had covered the bony surface of mandibular condyle. At 60 days, the newly formed cartilagenous joint surface became glossy, and the morphology and arrangement of cells tended to be regular simulating the morphology of normal articular cartilage. From the experiment, it could be concluded that (1) The autogenous perichondrium graft placed on the condylar surface of mandible could form new articular cartilage which was similar in tissue morphology to the normal condylar cartilage. (2) The process of development of newly formed cartilage was similar to that of the normal cartilage. (3) The motion and loading on the joint could promote the formation of new cartilage and undergo biological reformation, gradually resulting in normal joint morphology. On this basis, the clinical application of autogenous perichondrium graft to repair injured cartilage of the condylar process of the mandible was feasible.
Objective To compare biological characteristics between articular chondrocyte and meniscal fibrochondrocyte cultured in vitro andto investigate the possibility of using cultured cartilage as a substitute for meniscus.Methods Chondrocytes isolated from articular cartilage and meniscus of rabbits aged 3 weeks were respectively passaged in monolayer and cultured in centrifuge tube. Cartilages cultured in centrifuge tube and meniscus of rabbit aged 6 weeks were detected by histological examination and transmission electron microscopy. Growth curves of articular chondrocytes and meniscalfibrochondrocytes were compared; meanwhile, cell cycles of articular chondrocytes and meniscal fibrochondrocytes in passage 2and 4 were separately measured by flow cytometry.Results Articular chondrocytes in passage 4 were dedifferentiated. Articular chondrocytes formed cartilage 2 weeks after cultivation in centrifuge tube, but meniscal fibrochondrocytes could not generate cartilage. The differences in ultrastructure and histology obviously existed between cultured cartilage and meniscus; moreover, apoptosis of chondrocytes appeared in cultured cartilage. Proportion of subdiploid cells in articular chondrocytes passage 2 and 4 was markedly higher than that in passage 2 and 4 fibrochondrocytes(Plt;0.05). Conclusion Meniscal fibrochondrocytes can not form cartilage after cultivationin centrifuge tube, while cartilage cultured in centrifuge tube from articular chondrocytes can not be used as graft material for meniscus. Articular cartilage ismarkedly different from meniscus.
In order to investigate the effect of motion on repairing articular cartilage defect following autogenous periosteal graft, sixty adult rabbits were divided randomly into three groups: out-cage motion (OCM), in-cage motion (ICM) and immobilization (IMM). A defect of the articular cartilage, 1 cm x 0.5 cm in size, was made in the patellar-groove of femur of each hind limb. Free autogenous periosteal graft from the proximal tibia was sutured on the base of the left defect, while the right limb was served as control. The animals were sacrificed at 4, 8 and 12 weeks, respectively, after operation. The regeneration of the cartilage implanted was observed through gross, histology, histochemical assay and electronic microscope. The influence of different amount of motion on the chondrogenesis from the periosteal implant was also compared. The result showed that the hyaline cartilage produced from periosteal implant could be capable to repair full-thickness of articular cartilage. From statistical study, there was significant difference between OCM and ICM groups (P lt; 0.05), ICM and IMM (P lt; 0.05) as well as OCM and IMM (P lt; 0.01). It was suggested that the periosteal graft was effective in repair of defect of articular cartilage and the amount of motion was important for chondrogenesis.
ObjectiveTo evaluate the effect of bone cement filling on articular cartilage injury after curettage of giant cell tumor around the knee. MethodsFifty-three patients with giant cell tumor who accorded with the inclusion criteria were treated between January 2000 and December 2011, and the cl inical data were retrospectively analyzed. There were 30 males and 23 females, aged 16-69 years (mean, 34.2 years). The lesion located at the distal femur in 28 cases and at the proximal tibia in 25 cases. According to Campanacci grade, there were 6 patients at grade I, 38 at grade Ⅱ, and 9 at grade Ⅲ. Of 53 patients, 42 underwent curettage followed by bone cement fill ing, and 11 received curettage followed by bone grafts in the subchondral bony area and bone cement fill ing. Two groups were divided according to whether secondary osteoarthritis occurred or not during postoperative follow-up. The gender, age, lesion site, the subchondral residual bone thickness, tumor cross section, preoperative Campanacci grade, subchondral bone graft, and Enneking function score were compared between 2 groups, and multivariate logistic regression analysis was done. ResultsAll incisions healed by first intention. The average follow-up time was 65 months (range, 23-158 months). Of 53 cases, 37 (69.8%) had no osteoarthritis, and 16 (30.2%) had secondary osteoarthritis. Three cases (5.7%) recurred during the follow-up period. Univariate logistic regression analysis showed no significant difference in gender, age, lesion site, and Campanacci grade between 2 groups (P>0.1); difference was significant in the subchondral residual bone thickness, tumor cross section, Enneking function score, and subchondral bone graft (P<0.1). The multivariate logistic regression analysis showed that the decreased subchondral residual bone thickness, the increased tumor cross section, and no subchondral bone graft are the risk factors of postoperative secondary osteoarthritis (P<0.05). ConclusionCurettage of giant cell tumor around the knee followed by bone cement filling can increase the damage of cartilage, and subchondral bone graft can delay or reduce cartilage injury.
【Abstract】 Objective To investigate the protective effect of early motion on articular cartilage after joint allograft by performing a controlled trial between different post-operation strategies after joint allograft in an animal model. Methods Twenty hemi-knee joints were harvested from 10 6-month-old New Zealand white rabbits (male or female, weighing 2.5-3.0 kg); 10 hemi-knee joints by deep frozen treatment (donors) were transplanted to unilateral knee joints (recipients) of 10 6-month-old Chinchilla rabbits (male or female, weighing 2.5-3.0 kg), which were divided into early motion group (n=5) and sustained fixation group (n=5); and 10 hemi-knee joints were used as blank control (n=5) and frozen control (n=5). The articular cartilage of allogenic joints was detected by X-ray film, gross, and histology at 6 weeks after operation. Results Gross observation: no obvious limitation of joint movements was observed in early motion group, but obvious limitation in sustained fixation group. X-ray films: the bone ends between donor and recipient healed well with good paraposition and alignment on the operation day and 2 weeks after operation; at 6 weeks, angulation deformity was observed in early motion group of 3 rabbits, and paraposition and alignment were satisfactory in sustained fixation group. Histological observation: HE staining showed that the chondrocytes had normal quantity and morphology with few nuclear fragmentation and karyolysis in early motion group, but the quantity of chondrocytes sharply decreased with dissolved nuclei and numerous fibrous tissues in the cartilage matrix in sustained fixation group. The cell survival rate of the early motion group (49.66% ± 2.15%) was significantly higher than that of the sustained fixation group (20.68% ± 1.24%) (P lt; 0.05). Scanning electron microscopy observation: nuclear membrane was intact with chromatin condensation and edema of mitochondria and rough surfaced endoplasmic reticulum in early motion group, and that the membrane of chondrocyte vanished with blurring border between chondrocyte and matrix, rupture of nuclear membrane and the disappearance of chromatin and organelles could be found in sustained fixation group. Conclusion Early motion has protective effect on articular cartilage after joint allograft, but cannot completely prevent degeneration of the allogenic articular cartilage.
Objective To review the latest progress of seeding cells for articular cartilage tissue engineering. Methods The recent original l iteratures on seeding cells for articular cartilage tissue engineering were extensively reviewed. Results The chondrocytes derived from BMSCs’ differentiation would be a main source of seeding cells articular cartilage for tissue engineering. Three-dimensional scaffolds and cultivation surroundings played important roles in the field of articular cartilage tissue engineering. Conclusion The util ization of cytokine and transgenic technology as well as improvements of three-dimensional scaffolds and cultivation surroundings will promote the development of articular cartilage tissue engineering.
Objective Platelet-rich plasma (PRP) can enhance the chondrocyte prol iferation and repair of cartilage defects. To explore the safety and efficacy of intra-knee-articular injection of PRP to treat knee articular cartilage degeneration by comparing with injecting sodium hyaluronate (SH). Methods Thirty consecutive patients (30 knees) with knee articular cartilage degeneration were selected between January 2010 and June 2010. According to different injections, 30 patients wererandomly divided into PRP group (test group, n=15) and SH group (control group, n=15). There was no significant difference in gender, age, body mass index, and Kellgren-Lawrence grade between 2 groups (P gt; 0.05). Test group received 3.5 mL of PRP intra-knee-articular injections while control group received 2 mL of SH during the same time period. Both treatments were administered in series of 3 intra-knee-articular injections at 3-week intervals. Then, adverse reactions were recorded. International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Lequesne index were used for evaluation of treatment results. Results The patients of 2 groups were followed up 6 months. There were significant differences in IKDC score, WOMAC score, and Lequesne index between pre- and post-injection in 2 groups (P lt; 0.05); no significant difference was found between different time points (3, 4, and 6 months) in test group (P gt; 0.05), while significant differences were found between the postoperative 6th month and the postoperative 3rd and 4th months in control group (P lt; 0.05). There was no significant difference in IKDC score, WOMAC score, and Lequesne index between 2 groups within 4 months (P gt; 0.05), but the effectiveness of test group was significantly better than that of control group at 6 months after injection (P lt; 0.05). Adverse reactions occurred in 12 patients (31 injections) of test group and in 12 patients (30 injections) of control group. No significant difference in onset time, termination time, and duration of adverse reactions were found between 2 groups (P gt; 0.05). Conclusion Intra-knee-articular injection of PRP to treat knee articular cartilage degeneration is safe, which can alleviate symptoms of pain and swell ing and improve the qual ity of l ife of patients; however, further data of large samples and long-term follow-up are needed to confirm the safety and effectiveness.
The repair of defects of articular cartilage has continued to be a difficult problem. This article provided a collective review from literature pertaining to the advances gained in the repair of cartilaginous defects. In the spontaneous repair, if the defect of the cartilage was less than 3 mm, might result in complete or partial repair, but in those the diameter was more than 3 mm, the defect could not be repaired by normal cartilage. Although the cartilaginous autograft could give good result, but it could not be widely applied because short of supply of the autogenous cartilage. Cartilagious allograft could not be taken to repair cartilaginous defect because of reaction from tissue rejection. The transplantation of periosteal or perichondral graft had been tried but was eventually abandoned because of poor long-term result. The transplantation of free chondrocytes might be a method of hope. In general, transplantation of free chondrocytes into the cartilaginous defect will be lost. The supply of autogenous chondrocytes was very limited, and the heterogenous chondrocytes would inflict immunoreaction after being transplanted. In late of 1980, a new concept of tissue engineering was proposed. The problem that a scaffold of appropriate material which could hold the free chondrocytes in place from being lost might undergo proliferation and differentiation into new cartilage was far from being solved. Although tissue engineering still had various problems needed further investigation, but it will probably be the main direction of development in this field.
To explore the shape and structure of calcified cartilage zone and its interface between the non-calcified articular cartilage and subchondral bone plate. Methods The normal human condyles of femur (n=20) were obtained from the tissue bank donated by the residents, 10 males and 10 females, aged 17-45 years. The longitudinal and transverse paraffin sections were prepared by the routine method. The shape and structure of calcified cartilage zone were observed with theSafranin O/fast green and von kossa stain method. The interface conjunction among zones of cartilage was researched by SEM and the 3D structural model was establ ished by serial sections and model ing technique. Results Articular bone-cartilage safranin O/fast green staining showed that cartilage was stained red and subchondral bone was stained blue. The calcified cartilage zone was located between the tidemark and cement l ine. Von kossa staining showed that calcified cartilage zone was stained black and sharpness of structure border. Upper interface gomphosised tightly with the non-calcified cartilage by the wave shaped tidemark and lower interface anchored tightly with the subchondral bone by the uneven comb shaped cement l ine. The noncalcified cartilage zone was interlocked tightly in the manner of “ravine-engomphosis” by the calcified cartilage zone as observed under SEM, and the subchondral bone was anchored tightly in the manner of “comb-anchor” by the in the calcified cartilage zone 3D reconstruction model. Conclusion The calcified cartilage zone is an important structure in the articular cartilage. The articular cartilage is fixed firmly into subchondral bone plate by the distinctive conjunct interfaces of calcified cartilage zone.
Objective To investigate the possibility of sheep joint cartilage defect repair with tissue engineered cartilage constructed by using porous bioceramics as scaffold and TGF-β induced autologous bone marrow derived mesenchymal stem cells(MSCs) as seed cell. Methods In the experimental group(n=12), autologous MSCs were isolated and expanded in vitro and then implanted into the pre molded porous β-TCP; the cell β-TCP complex was implanted into sheep right humeral cartilage defect. The defects in β-TCP (n= 12) group were repaired by B-TCP only, while defects in the control group (n= 4) were left un-repaired. Samples were extracted 12 and 24 weeks after operation for histological, histochemical and immunohistochemical analysis. Results In the experimental group, cartilage-like tissue formation could be seen on the surface of the implants. Microscopic analysis demonstrated obvious degradation of B-TCP and extensive new cartilage formation 12 weeks after operation, containing rich extracellularmatrix. The cells were stained positively with type II collagen. The bioceramics had almo st completely been degraded and abundant cartilage formation could be seen in the whole defects 24 weeks later. In the B-TCP group, marginal cartilage ingrowth could be seen 12 weeks after operation and the number of chondrocytes increasedmarkedly after 24wee s. However, no cartilage can be found in the middle of the material. In the control group, only a small quantity of new cartilage formation could be seenalong the margin of defects. Conclusion It is feasible to generate tissue engineered cartilage with porous B-TCP and auto logousM SCs for cartilage defect repair.