犬同种异体半月板移植研究

发布时间：2018-05-13 14:28

本文选题：半月板 + 移植　；参考：《西北农林科技大学》2015年硕士论文

【摘要】：目的:半月板在膝关节功能中起着关键作用,半月板损伤往往会导致骨关节炎和膝关节功能障碍。本研究通过建立犬半月板损伤模型,随后进行不同形式的同种异体半月板移植修复,摸索有效的半月板损伤治疗方法,也为人医对半月板损伤的治疗提供参考。方法:将1 6只杂种犬分为全移植组、半移植组、不移植组和正常对照组,每组4只。全移植组:对试验犬进行右膝内侧半月板全切术并进行同种异体半月板移植。半移植组:对试验犬进行左膝内侧半月板前半部切除术并进行同种异体半月板移植。不移植组:对试验犬进行右膝内侧半月板全切除术和左膝内侧半月板前半部切除术,切除的半月板作供体备用。正常对照组:不进行任何操作。术后第6周对各组进行大体观察及膝关节功能Lysholm评分、关节液检查、剖检、组织学观察、胫骨平台软骨Mankin’s评分。结果:术后第5周末,所有移植犬站立、行走和上台阶均趋于正常,但不移植对照犬行走时仍有轻度跛行,上台阶困难。术后第6周,膝关节功能Lysholtn评分结果显示,全移植组和半移植组与正常对照组差异不显著,不移植组与正常对照组差异显著。关节液检查无感染。移植组关节液成分和正常对照组基本一致,但不移植组炎性细胞增多。剖检见供体半月板在受体内生长良好,其位置未发生变化。全移植组半月板和关节囊愈合良好,其表面有类似滑膜的组织出现。半移植组供体半月板的色泽和弹性更接近正常半月板。不移植组有少量周围组织长入胫骨平台边缘,关节软骨磨损严重,股骨髁表面粗糙。组织学观察,供体半月板和受体关节囊、供体半月板和保留的受体半月板细胞融合良好,接合处组织生长旺盛。胫骨平台软骨观察显示,全移植组各层分界清晰,但局部潮线弯曲;半移植组接近正常关节软骨;不移植组软骨表面有不规则裂隙,细胞弥散性增多,潮线紊乱。胫骨平台软骨Mankin’s评分显示,全移植组和半移植组与对照组差异不显著,不移植组与对照组差异显著。结论:犬半月板移植手术方法是可行的。同种异体半月板移植能够有效保护胫骨平台软骨、改善膝关节功能,完全可以用于治疗犬半月板损伤。
[Abstract]:Objective: meniscus plays a key role in knee joint function. Meniscus injury often leads to osteoarthritis and knee joint dysfunction. In this study, a canine meniscus injury model was established, and then different forms of allograft meniscus transplantation were carried out to explore the effective meniscus injury treatment method, and to provide a reference for the treatment of meniscus injury. Methods: sixteen mongrel dogs were divided into total transplantation group, semi transplantation group, non transplantation group and normal control group, with 4 dogs in each group. Total transplantation group: the right knee medial meniscus and allogeneic meniscus transplantation were performed. Half transplantation group: left knee medial meniscus anterior resection and allograft meniscus transplantation. No transplantation group: total resection of medial meniscus of right knee and anterior resection of medial meniscus of left knee were performed. Normal control group: no operation was performed. At the 6th week after operation, gross observation and Lysholm score of knee joint function, joint fluid examination, dissection, histological observation and Mankin's score of tibial plateau cartilage were carried out in each group. Results: at the end of the 5th week after operation, all the dogs tended to stand, walk and step up to normal, but the dogs without transplantation still had mild lameness and difficulty in walking. At the 6th week after operation, the Lysholtn score of knee joint function showed that there was no significant difference between the total transplantation group and the semi-transplantation group and the normal control group, but the difference between the non-transplantation group and the normal control group was significant. No infection was detected in joint fluid. The components of joint fluid in the transplantation group were basically the same as those in the normal control group, but the inflammatory cells were increased in the non-transplantation group. The results showed that the donor meniscus grew well in the recipient body and the position of the donor meniscus did not change. The meniscus and articular capsule healed well and synovial tissue appeared on the surface of the whole transplantation group. The color and elasticity of the donor meniscus were closer to the normal meniscus in the half transplantation group. In the non-transplantation group, a small amount of surrounding tissue grew into the edge of the tibial plateau, the articular cartilage was badly worn and the surface of the femoral condyle was rough. Histologically, the donor meniscus and the recipient joint capsule, the donor meniscus and the reserved recipient meniscus cells fused well, and the tissue at the junction grew well. The observation of tibial plateau cartilage showed that the boundary of each layer was clear, but the local tide line was bent; the half transplantation group was close to normal articular cartilage; the cartilage surface of non-transplantation group had irregular fissure, cell dispersion increased and tidal line disorder. The Mankin's score of tibial plateau cartilage showed that there was no significant difference between the total transplantation group and the half transplantation group and the control group, but the difference between the non-transplantation group and the control group was significant. Conclusion: the method of meniscus transplantation is feasible. The allograft meniscus transplantation can effectively protect the tibial plateau cartilage and improve the knee joint function. It can be used in the treatment of canine meniscus injury.
【学位授予单位】：西北农林科技大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

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