Medium and Long-Term Animal Experiment Study on Replacement of Allogeneic Meniscus Tissue for Repairing Cartilage Defects
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Revista Argentina de Clínica Psicológica
2020, Vol. XXIX, N°5, 35-41 35
DOI: 10.24205/03276716.2020.1004
Medium and Long-Term Animal Experiment Study on
Replacement of Allogeneic Meniscus Tissue for
Repairing Cartilage Defects
Heng Lia，Yongjian Yuanb，Huibin Tangc，Yi Xud，Zhenguo Sune，Jikang Minf*
Abstract
Objective: To explore the repair effect of allogeneic meniscus replacement cartilage graft
on animal articular cartilage.
Methods: The rabbit cartilage defect model was constructed, and allogeneic meniscus
tissue replacement transplantation was performed. Gross observation, cytological
observation, and histomorphological score were performed on the knee joint 2 months
after operation, and the biomechanical properties were analyzed. Furthermore, Western
blotting and ELISA were used to determine the expression of key proteins, Real-time RT-
PCR technology was used to detect the expression of key genes, and logistic regression
analysis was used to screen out the time points and key genes/proteins that affect the
efficacy.
Results: Through gross observation, it was found that the height, texture and color of
cartilage tissue repaired by meniscus transplantation were closer to normal cartilage, and
the repair degree was higher than that of cartilage transplantation group. At the same
time, the analysis of biomechanical properties showed that the ultimate stress, ultimate
strain, compressive modulus and tangent modulus of the meniscus transplantation group
were significantly higher than those of the cartilage transplantation group at December
and 18 months (P36 Heng Li，Yongjian Yuan，Huibin Tang，Yi Xu，Zhenguo Sun，Jikang Min
found to have cartilage defects [2]. In the early conditions, drill a circular 5mm×5mm×3mm full-
stage of cartilage defect, patients often have no thickness articular cartilage from the articular
obvious symptoms due to the small defect area. As surface of the femoral condyle and trochlear defect.
the disease progresses, the defect area increases, The subchondral layer of the defect shows micro-
and the patient will experience symptoms of joint hemorrhage and no cartilage remains. The defect is
swelling and pain. If the lesions cannot be treated as required the meniscus or cartilage is implanted,
in time and effectively, osteoarthritis may occur [3]. specifically, the cryopreserved meniscus/cartilage
At present, effective repair of cartilage defects is tissue is re-warmed and trimmed to the size of the
the current research focus. drilled hole. The bone hole in the receiving area is
slightly expanded with a dilator, and then trimmed
1. Introduction with an ejector. The finished allomeniscal/cartilage
In recent years, research on MAT has provided tissues are embedded into the defect one by one
new solutions for cartilage defect repair. Previously, and glued with protein gel. After implanting the
some researchers also confirmed that MAT has a graft, the patella was reset, and the knee joint
good and reliable repair effect on focal cartilage capsule and skin were sutured layer by layer.
defects on the weight-bearing surface of rabbit Penicillin was given intramuscular injection every
knee joints [4]. However, the medium and long- day for 3 days after operation to prevent infection.
term efficacy of MAT is not yet clear. After MAT, The limbs were not fixed and were free for
whether it will change the weight-bearing capacity movement. In the first week, 2 weeks, 1 month, 2
of articular cartilage, and how cartilage cells and months, 6 months, 12 months and 18 months after
matrix have changed at the nucleic acid and protein the operation, each group of rabbits were Put the
molecular level during the damage and repair of the to death and materials were collected.
medium and long-term cartilage tissue, thereby
inducing the repair or degeneration of cartilage 2.3 Analysis of biomechanical properties
tissue? It is a key point worth investigating. In December the specimens were obtained after
Therefore, in this study, frozen tissues were used 18 months, the mechanical properties were tested
for MAT and OAT respectively, and it was planned on the Instron 5544 material testing machine [7].
to follow up and observe the changes in the cell The cartilage ultimate stress, ultimate strain,
morphology and biomechanical properties of compressive modulus and tangent modulus of
articular cartilage and the transcription and cartilage tissue are calculated according to the
translation levels of cartilage-related characteristic parameters of cartilage tissue height, diameter,
proteins during the medium and long-term process cross-sectional area, load increment and material
of damage repair. Through the above research, the deformation.
biomarkers of regeneration/degradation of
cartilage tissue in the middle and long-term damage 2.4 Determination of key protein content
repair process are discovered to guide the After obtaining tissue samples, homogenize or
adjustment of treatment strategies and extend the grind with liquid nitrogen, CTX-II antibody ELISA kit
normal use time of articular cartilage after (Haring Biotechnology, HL95014) were used to
transplantation. detect CTX-II expression, rabbit matrix
metalloproteinase ELISA kit (Jianglai Biotechnology,
2. Methods and materials JL17211-48T) was used for the determination of
2.1 Experimental animal grouping MMP3, refer to the instructions for the specific
80 New Zealand rabbits (SPF grade) either male method. Type collagen II and collagen type X were
or female, weighing about 2.5 kg. The animals were measured by immunoblotting method [8] to
randomly divided into MAT group and OAT group, determine their average gray values.
40 per group, MAT group is given meniscus
transplantation, OAT group is given cartilage 2.5 Real-time RT-PCR technology detects the
transplantation. expression of key genes
The total RNA of tissue samples was extracted,
2.2 MAT/OAT and the expression of col2a1, col10a1, mmp3, and
After 80 New Zealand rabbits were given CTX-II genes were detected after reverse
intravenous anesthesia, the rabbits’ knees and transcription. The primers were synthesized by
surrounding hair were shaved, and the rabbits were Shanghai Shenggong Co., Ltd., the probes used
fixed in the supine position on the operating table Roche's Universal Probe Libreary probe for real-
and then the knees were disinfected. Under aseptic time PCR detection, the FAM channel detects the
REVISTA ARGENTINA
2020, Vol. XXIX, N°5, 35-41 DE CLÍNICA PSICOLÓGICA37 Heng Li，Yongjian Yuan，Huibin Tang，Yi Xu，Zhenguo Sun，Jikang Min signal, and β-actin was used as the internal histomorphology score of the MAT group was standard gene. The relative expression rate (RE) of significantly higher than that of the OAT group the target gene of the sample is calculated using the (P
38 Heng Li，Yongjian Yuan，Huibin Tang，Yi Xu，Zhenguo Sun，Jikang Min
from 1 month after surgery to 2 months after week to 18 months after surgery, the expression of
surgery. From 2 months after surgery to 18 months mmp3 in the two groups showed a downward
after surgery, the expression of col10a1 showed a trend. Among them, the expression of mmp3
downward trend. The col10a1 expression value of between the two groups was compared at 12 and
the two groups was compared, and the difference 18 months, and the difference was statistically
was not statistically significant (P>0.05). The significant. The expression of key proteins related
expression levels of mature cartilage matrix to cartilage degeneration is consistent with the
synthesis-related genes are consistent with the change trend of key protein expression. See Figure
changes in key protein expression levels. From 1 3 for details.
Figure 2. mean expression of key proteins at different time points，A:collagen type II ;B:collagen type
X;C:MMP3;D:CTX-II。*P39 Heng Li，Yongjian Yuan，Huibin Tang，Yi Xu，Zhenguo Sun，Jikang Min
2.5 Logistic regression analysis after surgery was the time point that significantly
According to the expression results of key affected the efficacy，collagen type II、col2a1 for
proteins and genes, logistic regression analysis was the key proteins and genes that significantly affect
performed, and the results showed that one month the efficacy
Table 3. Logistic regression analysis screening time points
95.0% CI for Exp(B)
Factor B SE Wald df Sig. Exp
Lower Upper
2 weeks after surgery -0.430 0.395 1.201 1 0.268 0.650 0.300 1.405
1 month after operation 1.129 0.416 7.293 1 0.007 3.094 1.361 7.026
12 months after surgery 0.395 0.232 2.898 1 0.089 1.485 0.942 2.34
18 months after surgery 0.432 0.362 1.423 1 0.233 1.54 0.758 3.132
Table 4. Logistic regression analysis to screen key proteins/genes
95.0% CI for Exp(B)
Factor B SE Wald df Sig. Exp
Lower Upper
collagen type II -1.182 0.521 5.154 1 0.023 0.307 0.111 0.851
MMP3 0.306 0.433 0.5 1 0.48 1.358 0.581 3.175
CTX-II 0.473 0.371 1.633 1 0.201 1.606 0.777 3.319
col2a1 -1.435 0.516 7.730 1 0.005 0. 238 0.087 0.655
4. Discussion allogeneic meniscus replacement transplantation
Knee cartilage injury is a problem frequently to repair cartilage defect tissue in an animal model.
encountered by orthopedic surgeons. According to The results found that the height, texture, and color
statistics, 4%-10% of young people aged 15-24 in of the repaired tissue in the MAT group were close
my country have cartilage disease, and about 80% to normal cartilage at 2 months after the operation,
of people over 55 have cartilage Lesions [3]. The and the surface had no depression and Smooth, HE
regenerative capacity of articular cartilage defects and toluidine blue staining microscopic
is limited, which may lead to early-onset examination showed that the number of new
osteoarthritis. Cartilage defects can simultaneously chondrocytes was higher than that in the OAT
make the patient very weak, resulting in a quality of group, and the arrangement was similar to normal
life similar to that of patients with severe knee cartilage. The above results suggested that the
osteoarthritis waiting for total knee replacement. replacement of allogeneic meniscus
Currently, there are limited clinical methods for transplantation to repair cartilage defects has a
repairing articular cartilage damage. Non-steroidal definite repair effect.
drugs, hormones and other drugs can only relieve At present, frozen osteochondral grafts are
pain but cannot slow down joint degeneration. more commonly used in allogeneic transplantation.
Surgical treatment is the main option for this The reason is that compared with fresh cartilage,
disease. Clinically, the surgical treatment of frozen osteochondral grafts can be operated on an
cartilage defects includes autologous elective basis and have ample time for multiple
osteochondral transplantation, allogeneic tests to prevent viral or bacterial infection and
osteochondral transplantation, etc., and they have spread. It has advantages such as low immunity.
achieved certain effects [9]. However, long-term studies have confirmed that
The meniscus is the fibrous cartilage in the knee various aspects of the freezing process, such as the
joint. Its main function is to make the joint fluid cooling rate, the type of cryoprotectant, and other
easily diffuse and reduce local friction. MAT was factors, have varying degrees of influence on the
originally a mature surgical treatment suitable for cartilage tissue. The elastic coefficient and viscosity
partial or total removal of the meniscus [10-11], coefficient of the cartilage tissue after freezing
which can relieve pain and improve function [12- allograft cartilage have obvious effects. It changes
14]. In addition, there are reports that MAT can the degradation of cartilage matrix appear [16].
alleviate the progression of osteoarthritis [15]. Therefore, the allogeneic osteochondral
Research on the replacement of allogeneic transplantation technique may cause pathological
meniscus transplantation to repair cartilage defects changes such as the degeneration of the
is currently rare. Therefore, this study first applied transplanted cartilage and the decrease in load
REVISTA ARGENTINA
2020, Vol. XXIX, N°5, 35-41 DE CLÍNICA PSICOLÓGICA40 Heng Li，Yongjian Yuan，Huibin Tang，Yi Xu，Zhenguo Sun，Jikang Min capacity in the middle and long-term clinical protein showed a downward trend from 1 month observation. Some key proteins can indirectly after surgery to 18 months after surgery. Among reflect specific conditions and help us investigate them, when comparing the average values of the medium and long-term effects of allogeneic collagen type II protein expression in the two meniscus replacement transplantation in repairing groups at 1 week, 2 weeks, and January, the MAT cartilage defects. (Type collagen II) it is one of the group was significantly higher than the OAT group characteristic signs of articular cartilage. The repair (P
41 Heng Li，Yongjian Yuan，Huibin Tang，Yi Xu，Zhenguo Sun，Jikang Min
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