编织状蚕丝—胶原海绵支架对前交叉韧带重建和骨关节炎预防长期效果的研究
发布时间：2018-11-09 07:22
【摘要】：背景和目的 随着我国国民对品质生活和健康体魄需求的提升,运动健身已逐渐成为日常生活中的重要组成部分,国人参加体育锻炼和竞技运动的数量明显增加,运动损伤也随之增加。近十年来,作为关节腔内维持膝关节稳定和功能运动的重要韧带,前交叉韧带(Anterior cruciate ligament, ACL)损伤后的组织学重建和生物力学功能恢复越来越受到骨科医生的极大关注。由于相对缺乏血供,种子细胞不足以及关节腔恶劣的液态环境,ACL再生能力非常有限,因此其损伤后的功能性修复在临床治疗中仍然面临巨大挑战。当前,自体移植、同种异体移植一直是修复ACL的金标准。然而,这些手术重建再生技术有不同的弊端,例如供体部位并发症、疾病传播、免疫排斥、较差整合性和较高的复发率。近年来,人工韧带的出现为提高ACL等软组织的修复质量带来了全新的希望。 已经面市的商业化产品大多为不可降解的合成材料。他们虽然克服自体和异体移植的弊端,在短期内产生令人满意的效果,然而长期随访发现依然会引起包括移植物破裂,骨关节炎发生,慢性滑膜炎和异物反应等不良事件。 近来,基于蚕丝的生物材料由于其良好的生物相容性和较大的力学强度被广泛应用于各种软组织的修复。有研究显示单纯捆绑型蚕丝支架用于ACL修复取得了一定效果,我们先前运用“内部空间预占”理论原创性的设计了一种编织状蚕丝-胶原海绵支架用于皮下肌腱韧带再生取得了满意效果。本研究将进一步探索其用于关节腔恶劣液态环境中的前交叉韧带重建的长期效果,并评估其对骨关节炎的预防效果。 方法和结果 1、编织状蚕丝-胶原海绵材料的制备和性能检测：复合蚕丝胶原材料的制备是通过在模具中加入10ml10%胶原溶液和编织状蚕丝,经过冷冻真空干燥法和真空干热交联法。最后制得的复合材料通过力学测试仪检测其力学性能。 2、运用兔间充质干细胞(MSC)进行体外相容性实验：将蚕丝-胶原复合材料与MSC共培养,3、7、14天之后,运用扫描电镜(SEM)观察材料表面细胞形态,1、3、7、10、14天之后,通过细胞计数试剂盒-8(CCK-8)方法检测细胞的增殖情况并评估材料的体外相容性。 3、单纯蚕丝组和蚕丝胶原组分别与MSC共培养,3、7天之后,通过转录因子(mRNA)检测I型胶原(COL Ⅰ)、黏蛋白(TNC)、双糖链蛋白多糖(BGN)、核心蛋白多糖(DCN)并完成统计分析,评估实验组对成腱分化的影响。 4、前交叉韧带(ACL)重建模型复合支架体内移植评估ACL修复能力：将实验组蚕丝胶原复合支架和对照组单纯蚕丝支架分别植入建立的兔前交叉韧带重建模型。术后2个月、6个月、18个月分别进行组织学染色及评分、三色染色、腱系因子表达检测、I型胶原(COL Ⅰ)、III型胶原(COL Ⅲ)免疫组化以及偏正光评估腱性部位修复情况。并对2个月和18个月进行胶原含量检测。同时运用SO染色和micro-CT对腱骨交界处进行评估。 5、骨关节炎(OA)预防的疗效评估：通过对关节面进行墨汁染色、SO染色组织学评分、半月板HE染色以及关节X线评估OA进程。 结果显示蚕丝胶原支架相比单纯蚕丝支架拥有更好的力学性能,体外细胞共培养有效促进了MSC的粘附、增殖和腱性因子的表达,体内移植2个月蚕丝胶原支架组显著提高了迁移和粘附的梭形细胞,并于术后6个月发现再生组织可表达更多的腱系因子和表现出更自然的韧带微结构表型,进一步在术后18个月,编织状蚕丝胶原海绵支架呈现出具有更成熟的韧带结构和相对较好的骨腱愈合。同时关节腔内蚕丝胶原支架相比皮下降解更慢,而且在术后18个月可以看到蚕丝胶原支架组有效得保护了关节软骨面以及关节间隙维持在较理想宽度。 结论 本研究显示编织状蚕丝一胶原海绵支架可以促进ACL功能再生并在远期有效预防骨关节炎的发生,提示其可以作为一种功能性生物支架用于ACL的重建,为其临床转化奠定了实验基础。
[Abstract]:Background and Purpose With the improvement of the people's demand for quality and health, the sports body-building has gradually become an important part of daily life, and the number of people participating in the physical exercise and the competitive sports is obviously increased, and the sports injury also In the last 10 years, the histological and biomechanical function of the anterior cruciate ligament (ACL), which is an important ligament for maintaining the stability and functional movement of the knee joint in the joint cavity, is getting more and more affected by the orthopaedic surgeon. Concerned that the ability to regenerate the ACL is very limited due to the relatively short supply of blood, insufficient seed cells, and the poor liquid environment of the articular cavity, so that the functional restoration after injury still faces great challenges in the clinical treatment Challenge. Current, autograft, allografts have been the gold to repair the ACL Standards. However, these surgical reconstruction and regeneration techniques have different disadvantages, such as donor site complications, disease spread, immune rejection, poor heterozygosity, and higher complex In recent years, the appearance of the artificial ligament has brought a brand-new appearance to improve the quality of the soft tissue such as ACL Hope. The commercial products in the market are mostly non-degradable. Synthetic materials. They have a satisfactory effect in the short term, although they overcome the drawbacks of both autograft and allograft. However, long-term follow-up found that graft rupture, osteoarthritis, chronic synovitis, and foreign body reactions can still be caused. Recently, silk-based biological materials have been widely used for their good biocompatibility and high mechanical strength The repair of various soft tissues has shown that the simple binding type silk stent is used for ACL repair and has a certain effect. We have previously applied the 鈥渋nternal space preoccupation鈥，
本文编号：2319737
[Abstract]:Background and Purpose With the improvement of the people's demand for quality and health, the sports body-building has gradually become an important part of daily life, and the number of people participating in the physical exercise and the competitive sports is obviously increased, and the sports injury also In the last 10 years, the histological and biomechanical function of the anterior cruciate ligament (ACL), which is an important ligament for maintaining the stability and functional movement of the knee joint in the joint cavity, is getting more and more affected by the orthopaedic surgeon. Concerned that the ability to regenerate the ACL is very limited due to the relatively short supply of blood, insufficient seed cells, and the poor liquid environment of the articular cavity, so that the functional restoration after injury still faces great challenges in the clinical treatment Challenge. Current, autograft, allografts have been the gold to repair the ACL Standards. However, these surgical reconstruction and regeneration techniques have different disadvantages, such as donor site complications, disease spread, immune rejection, poor heterozygosity, and higher complex In recent years, the appearance of the artificial ligament has brought a brand-new appearance to improve the quality of the soft tissue such as ACL Hope. The commercial products in the market are mostly non-degradable. Synthetic materials. They have a satisfactory effect in the short term, although they overcome the drawbacks of both autograft and allograft. However, long-term follow-up found that graft rupture, osteoarthritis, chronic synovitis, and foreign body reactions can still be caused. Recently, silk-based biological materials have been widely used for their good biocompatibility and high mechanical strength The repair of various soft tissues has shown that the simple binding type silk stent is used for ACL repair and has a certain effect. We have previously applied the 鈥渋nternal space preoccupation鈥，
本文编号：2319737
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2319737.html
最近更新
教材专著
