| 自体骨软骨移植治疗兔复发性肩关节前脱位伴关节盂软骨缺损的实验研究 |
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Received:September 10, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘涛 |
LIU Tao |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 方森 |
FANG Sen |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 刘芳香 |
LIU Fang-xiang |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 张明涛 |
ZHANG Ming-tao |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 杨智涛 |
YANG Zhi-tao |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 张柏荣 |
ZHANG Bo-rong |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 梁钧文 |
LIANG Jun-wen |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 王锡豪 |
WANG Xi-hao |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 姜金 |
JIANG Jin |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 韵向东 |
YUN Xiang-dong |
兰州大学第二医院骨科, 甘肃 兰州 730030
甘肃省骨关节疾病研究重点实验室, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
Key Laboraotry of Bone and Joint Disease of Gansu Province, Lanzhou 730030, Gansu, China |
xiangdongyun@126.com |
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| 期刊信息：《中国骨伤》2025年38卷，第6期，第619-625页 |
| DOI：10.12200/j.issn.1003-0034.20230804 |
| 基金项目:甘肃省科技厅自然科学基金项目(编号:22JR11RA051) |
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目的：通过建立兔复发性肩关节前脱位伴<20%关节盂软骨缺损模型,探讨自体骨软骨移植(autologousosteochondral transplantation,AOT)治疗兔复发性肩关节前脱位伴关节盂软骨缺损的治疗效果。
方法：选取6月龄雄性新西兰大白兔24只,体重(2.69±0.17) kg,人为破坏兔肩关节盂唇建立复发性肩关节前脱位伴软骨缺损模型,分为AOT手术组和单纯缝手术合组,每组12只。AOT组采用AOT手术,单纯缝合组采用单纯Bankart缝合。分别于术后6、12周,两组各处死6只取材,观察并比较两组兔饮食情况、活动情况、精神状态及标本中移植物的愈合情况。HE染色观察细胞爬行、细胞形态、炎性细胞浸润、纤维软骨细胞及排列情况;Masson染色观察胶原纤维生成排列情况;番红-固绿染色观察关节软骨、软骨下骨及骨组织再生情况。采用Micro-CT测出两组关节盂区域骨密度(bone mineral den-sity,BMD)、骨体积(bone volume,BV)和骨小梁厚度(trabecular thickness,Tb.Th)等参数评估自体骨软骨对肩关节盂骨质缺损重塑情况。
结果：两组术后6周术侧肩关节外展、后伸、内旋与外旋较对侧活动度受限,内收和前屈较对侧无明显异常。术后12周,两组肩关节活动度已恢复至造模前状态。两组术后12周HE染色、Masson染色以及番红-固绿染色效果均强于术后6周的染色结果(P<0.05);且AOT组术后6、12周HE染色、Masson染色及番红固绿染色结果均高于单纯缝合组(P<0.05)。Micro-CT扫描结果显示,术后6、12周AOT组BMD[(0.427±0.014)、(0.466±0.032) g·cm-3]、BV[(116.171±3.527)、(159.327±3.500) mm3]、Tb.Th[(0.230±0.006)、(0.285±0.009) mm],均高于单纯缝合组的BMD[(0.358±0.011)、(0.384±0.096) g·cm-3]、BV[(72.657±3.903)、(118.713±3.860) mm3]、Tb.Th[(0.204±0.009)、(0.243±0.007) mm],差异有统计学意义(P<0.05)。
结论：AOT术可有效促进肩关节盂<20%软骨缺损处成骨和纤维软骨再生,有利于重塑肩关节盂结构。 |
| [关键词]:自体骨软骨移植 复发性肩关节脱位 软骨损伤 盂唇损伤 |
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| Experimental study on autologous osteochondral transplantation in the treatment of recurrent anterior dislocation of the shoulder joint with articular cartilage defect in rabbits |
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Abstract:
Objective To explore clinical effect of autologous osteochondral transplantation (AOT) in the treatment of recurrent anterior dislocation of the shoulder joint with glenoid cartilage defect in rabbits by establishing a model of recurrent anterior dislocation of the shoulder joint with < 20% glenoid cartilage defect in rabbits.
Methods Twenty-four male New Zealand white rabbits,aged 6-month-old,weighed (2.69±0.17) kg were selected. The labrum of shoulder joint of rabbits was artificially destroyed to establish a model of recurrent anterior dislocation of shoulder joint with cartilage defect. They were divided into AOT surgery group and simple suture group,with 12 rabbits in each group. AOT group were underwent AOT surgery,while simple suture group was treated with simple Bankart suture for recurrent shoulder joint dislocation. At 6 and 12 weeks after operation,6 rabbits between two groups were sacrificed for sampling. The dietary conditions,activity conditions,mental states of rabbits and healing conditions of grafts in the specimens were observed and compared between two groups. HE staining was used to observe cell creep,cell morphology,inflammatory cell infiltration,fibrochondrocytes and their arrangement. Masson staining was used to observe the formation and arrangement of collagen fibers; Safrane-green staining was used to observe the regeneration of articular cartilage,subchondral bone and bone tissue. Bone mineral density (BMD),bone volume (BV) and trabecular thickness (Tb.Th) between two groups were measured by Micro-CT to evaluate the remodeling of shoulder glenoid bone defects by autologous osteochondral cartilage.
Results After different surgical interventions were carried out in both groups of rabbits,at 6 weeks after the operation,the abduction,extension,internal rotation and external rotation of the shoulder joint on the operated side showed limited range of motion compared with the contralateral side,while adduction and forward flexion showed no obvious abnormalities compared with the contralateral side. At 12 weeks after operation,the range motion of tshoulder joints in both groups of rabbits had returned to the state before modeling. The effects of HE staining,Masson staining and safrane green staining at 12 weeks after operation in both groups were stronger than the staining results at 6 weeks after operation. Moreover,the results of HE staining,Masson staining and safranin fixation green staining in AOT group at 6 and 12 weeks after operation were all higher than those in simple suture group. Micro-CT scan results at 6 and 12 weeks after operation showed that BMD (0.427±0.014), (0.466±0.032) g·cm-3,BV (116.171 ±3.527), (159.327±3.500) mm3,and Tb.Th (0.230±0.006), (0.285±0.009) mm in AOT group,which were higher than those of simple suture group in BMD (0.358±0.011),(0.384±0.096) g·cm-3,BV(72.657±3.903),(118.713±3.860) mm3,and Tb.Th(0.204±0.009),(0.243±0.007) mm; and the differences were statistically significant (P<0.05).
Conclusion AOT procedure could effectively promote osteogenesis and fibrocartilage regeneration in the cartilage defect area of the shoulder glenoid <20%,which is conducive to reshaping the structure of the shoulder glenoid. |
| KEYWORDS:Autologous osteochondral transplantation Recurrent shoulder dislocation Cartilage injury Labrum injury |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘涛,方森,刘芳香,张明涛,杨智涛,张柏荣,梁钧文,王锡豪,姜金,韵向东.自体骨软骨移植治疗兔复发性肩关节前脱位伴关节盂软骨缺损的实验研究[J].中国骨伤,2025,38(6):619~625 |
| 英文格式: | LIU Tao,FANG Sen,LIU Fang-xiang,ZHANG Ming-tao,YANG Zhi-tao,ZHANG Bo-rong,LIANG Jun-wen,WANG Xi-hao,JIANG Jin,YUN Xiang-dong.Experimental study on autologous osteochondral transplantation in the treatment of recurrent anterior dislocation of the shoulder joint with articular cartilage defect in rabbits[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(6):619~625 |
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