【摘要】 目的 :观察组织工程技术联合早期康复对关节软骨缺损修复的影响。方法 :用Percoll密度梯度离心法分离羊自体骨髓间充质干细胞 (MSCs) ,体外扩增并与多孔生物陶瓷 β 磷酸三钙 ( β TCP)复合后手术植入羊右侧股骨内侧髁负重关节面缺损处 ( 8× 4mm)作为实验组 ,其中又分为术后给予康复干预的实验组 1和让其自由活动的实验组 2 ,并设空白组作为对照组。术后 12周取材 ,进行大体观察、组织学分析。结果 :实验组 1和 2的缺损修复区均生成外观透明的新生软骨 ,实验组 1新生软骨组织表面与周边正常软骨自然连续 ,平齐 ,而实验组 2修复平面略下陷 ;组织学均表现为 β TCP支架材料大部分降解 ,新生软骨组织基质异染明显。对照组缺损未得到明显修复。结论 :以 β TCP多孔生物陶瓷为支架材料 ,自体MSCs为种子细胞构建的组织工程化软骨具有明显的关节软骨缺损修复能力 ,辅以一定的康复干预措施更有利于关节软骨缺损的早期修复 ,显示了广阔的临床应用前景更多还原

【Abstract】 Objective: To investigate the effect of repairing articular cartilage defects by tissue engineering technique combined with early rehabilitation in a sheep model. Methods: Adult sheep MSCs were isolated from bone marrow aspirates by Percoll and culture expanded in vitro. The cell β TCP complex was implanted into articular cartilage defect, 8 mm in diameter and 4 mm in depth, which was created at the weight bearing areas of the medial condyl of right femus. Sheep received cell β TCP complex combined with early rehabilitation as experimental group 1, only cell β TCP complex as experimental group 2, nothing as blank control group. Samples were extracted 12 weeks postoperation for macroscopic observation, histological analysis. Results: In both of the experimental groups, cartilage like tissue formation could be seen on the surface of the implants at 12 weeks postoperation, looking ivory, smooth and not much distinguishable from adjacent normal cartilage, but the surface of neoregenerated cartilage in group 2 sunk slightly; Microscopic analysis demonstrated a similar hyaline cartilage structure with rich extracellular matrix positively stained by safranin ”O” and little undegraded β TCP particles still existed. In the blank control group, the defect area was unrepaired. Conclusion: Tissue engineered cartilage with a certain rehabilitation based on autologous MSCs seeded into β TCP can perfectly repair articular cartilage defects, and this approach is of great potential for clinical application.更多还原