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Matrix-associated autologous chondrocyte transplantation in a compartmentalized early stage of osteoarthritis

机译:骨关节炎早期分隔的基质相关自体软骨细胞移植

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Objective: Cartilage restoration in joints with an early stage of osteoarthritis (OA) is an important clinical challenge. In this study, a compartmentalized, early-stage OA was generated surgically in sheep stifle joints, and this model was used to evaluate a matrix-associated cell transplantation approach for cartilage repair. Method: Eighteen sheep were operated twice. During the first operation, a unicompartmental OA in a stable joint was induced by creating a critical-size defect. The second operation served as a regeneration procedure. The eighteen sheep were divided into three groups. One group was treated with spongialization (SPONGIO), while the two others had spongialization followed by implantation of a hyaluronan matrix with (MACT) or without chondrocytes (MATRIX). The follow-up took place 4 months after the second operation. Gross Assessment of Joint Changes score and Brittberg score were used for the macroscopic evaluation, Mankin score, O'Driscoll score, and immunohistochemistry for collagen type I and type II for histological evaluation. Results: The MACT group achieved significantly better results in both macroscopic and histological examinations. In the regeneration area, a Mankin score of 7.88 (6.20; 9.55) [mean (upper 95% confidence interval; lower 95% confidence interval)] was reached in the MACT group, 10.38 (8.03; 12.72) in the MATRIX group, and 10.33 (8.80; 11.87) in the SPONGIO group. The O'Driscoll score revealed a highly significant difference in the degree of defect repair: 15.92 (14.58; 17.25) for the MACT group compared to the two other groups [5.04 (1.21; 8.87) MATRIX and 6.58 (5.17; 8.00) SPONGIO; P < 0.0001]. Conclusion: This study demonstrates promising results toward the development of a biological regeneration technique for early-stage OA.
机译:目的:早期骨关节炎(OA)的关节软骨修复是一项重要的临床挑战。在这项研究中,通过手术在绵羊的窒息关节中产生了一个间隔期的早期OA,该模型用于评估基质相关的细胞移植方法来修复软骨。方法:对18只绵羊进行两次手术。在第一次手术中,通过产生临界大小的缺损,在稳定的关节中诱发了单室骨关节炎。第二操作用作再生程序。十八只羊分为三组。一组进行了海绵化治疗(SPONGIO),而其他两组进行了海绵化治疗,然后植入了透明质酸基质,其中加入了(MACT)或不加入软骨细胞(MATRIX)。在第二次手术后四个月进行了随访。大体评估关节变化评分和Brittberg评分用于宏观评估,Mankin评分,O'Driscoll评分以及I型和II型胶原的免疫组织化学用于组织学评估。结果:MACT组在肉眼和组织学检查中均取得了明显更好的结果。在再生区域中,MACT组的Mankin评分为7.88(6.20; 9.55)[平均值(95%置信区间上限; 95%的置信区间下限)],MATRIX组的Mankin评分为10.38(8.03; 12.72)。 SPONGIO组中的10.33(8.80; 11.87)。 O'Driscoll评分显示出缺陷修复程度的显着差异:MACT组为15.92(14.58; 17.25),而其他两组为[5.04(1.21; 8.87)MATRIX和6.58(5.17; 8.00)SPONGIO; P <0.0001]。结论:这项研究证明了早期OA的生物再生技术的发展前景可观。

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