ÖZET
Amaç:
Fokal kıkırdak defektlerinin tedavisinde hala orijinal kıkırdak dokusu sağlayan mükemmel bir yöntem yoktur, bu nedenle en iyi tedavi seçeneklerini bulmak için araştırmalar devam etmektedir. Bu çalışmada amaç, kıkırdak defektlerinde küçük çaplı delik (SDHM) ve geleneksel mikro kırık tedavilerinin iyileştirme kalitesini karşılaşmaktır. Bununla beraber delik yoğunluğunun ve defekti hyalüronik asit bazlı aselüler matriks (HA bazlı AM) ile desteklemenin kıkırdak iyileşmesi üzerindeki etkileri de incelenmiştir.
Yöntemler:
Yirmi bir Yeni Zelanda tavşanının her iki femur trochlear oluğunda 5 mm çapında ve 3 mm derinliğinde artiküler kıkırdak defekti oluşturuldu. Her biri 6 dizden oluşan yedi grup oluşturuldu. Tavşanlar 12 hafta sonra sakrifiye edildi ve rejenere kıkırdak Wakitani skorlama sistemi kullanılarak histolojik değerlendirme için toplandı.
Bulgular:
Tüm defektler rejenere doku ile makroskopik olarak dolduruldu. 1. Grup [14 (10-14) puan], VI [6 (1-11) puan] ve VII. [5 (3-10) puan] gruplara göre anlamlı derecede yüksek Wakitani skoruna sahipti (p=0.043 ve p=0.016 ). Diğer gruplar arasında anlamlı bir fark gözlenmedi. Hyaluronik asit bazlı aselüler matriks ile destekleme, kıkırdak iyileşmesine katkıda bulunmadı.
Sonuç:
SDHM yoğunluğunun artırılması, geleneksel mikro kırık ile karşılaştırıldığında kıkırdak iyileşmesini artırır. Hyalüronik asit bazlı aselüler matriks implantasyonu ile desteklenen SDHM’nin artırılması ise rejenere kıkırdak kalitesini artırmadı.
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