Düşük doz X ışınının hiyalin kıkırdak benzeri fibrokıkırdağın yapısal ve mekanik özellikleri üstündeki etkisi

Year 2013, Volume: 47 Issue: 2, 127 - 133, 26.04.2013

Tevfik Oncan Burak Demirag Cenk Ermutlu Ulviye Yalcinkaya Lutfu Ozkan

Abstract

Amaç: Bu çalışmanın amacı düşük doz X ışınının fibröz kıkırdak üzerindeki etkilerini araştırmak ve hiyalin kıkırdak ile aynı mekanik ve yapısal özelliklere sahip hiyalin kıkırdak benzeri fibrokıkırdak (HKBF) geliştirmek idi.
Çalışma planı: Yirmi tavşanın 40 diz ekleminde osteokondral defekt oluşturuldu. Ameliyat sonrası 7. günde başlanarak her tavşanın tek bir dizine, 5 gün boyunca, günlük 1.0 Gy'lik dozlarla toplam 5.0 Gy X ışını uygulanırken (radyoterapi grubu), diğer dizi uygulama dışı bırakıldı (kontrol grubu). Tavşanlar daha sonra her birinde 5 adet olacak şekilde 4 gruba ayrıldı. İlk üç grup, sırasıyla, 4., 8. ve 12. haftada sakrifiye edildi ve kıkırdak defektleri makroskopik ve mikroskobik olarak incelendi. Kalan 5 tavşanın oluşturduğu grup da 12. haftada sakrifiye edilerek kıkırdak defektlerine biyomekanik sıkıştırma testleri uygulandı.
Bulgular: Radyoterapi ve kontrol grupları arasında biyomekanik açıdan anlamlı bir fark saptanmadı (p=0.686). Yine, gruplar arasında makroskopik ve mikroskopik açıdan da anlamlı bir fark yoktu (p=0.300). Işınlanan grupta kondrosit kümelenmesi gözlendi.
Çıkarımlar: Düşük doz X ışını HKBF dokusunun mekanik özelliklerini in vivo etkilememekle birlikte, kondrosit kümelenmesi gibi yapısal değişikliklere yol açmaktadır.

Keywords

Düşük doz X ışını; hiyalin kıkırdak; hiyalin kıkırdak benzeri fibrokıkırdak; mekanik; yapısal.

Effect of low-dose irradiation on structural and mechanical properties of hyaline cartilage-like fibrocartilage

Abstract

Objective: The aim of this study was to analyze the effect of low-dose irradiation on fibrous cartilage and to obtain a hyaline cartilage-like fibrocartilage (HCLF) with similar structural and mechanical properties to hyaline cartilage.
Methods: An osteochondral defect was created in 40 knees of 20 rabbits. At the 7th postoperative day, a single knee of each rabbit was irradiated with a total dose of 5.0 Gy in 1.0 Gy fractions for 5 days (radiotherapy group), while the other knee was not irradiated (control group). Rabbits were then divided into four groups of 5 rabbits each. The first three groups were sacrificed at the 4th, 8th and the 12th postoperative weeks and cartilage defects were macroscopically and microscopically evaluated. The remaining group of 5 rabbits was sacrificed at the 12th week and biomechanical compression tests were performed on the cartilage defects.
Results: There was no significant biomechanical difference between the radiotherapy and the control group (p=0.686). There was no significant macroscopic and microscopic difference between groups (p=0.300). Chondrocyte clustering was observed in the irradiated group.
Conclusion: Low-dose irradiation does not affect the mechanical properties of HCLF in vivo. However, structural changes such as chondrocyte clustering were observed.

Keywords

Hyaline cartilage, hyaline cartilage-like fibrocartilage, low-dose irradiation, mechanical, structural

References

• Mankin HJ, Mow VC, Buckwalter JA. Articular cartilage repair and osteoarthritis. In: Buckwalter JA, Einhorn TA, Simon SR, editors. Orthopaedic basic science. Biology and biomechanics of the musculoskeletal system. 2nd ed. Rosemont, Illinois: American Academy of Orthopaedic Surgeons; 2000. p. 471-88.
• Buckwalter JA. Evaluating methods of restoring cartilaginous articular surfaces. Clin Orthop Relat Res 1999;(367 Suppl):S224-38.
• Mankin HJ. The response of articular cartilage to mechanical injury. J Bone Joint Surg Am 1982;64:460-6.
• Buckwalter JA, Coutts R, Hunziker E, Van Mow C. Breakout Session 3: Articular cartilage. Clin Orthop Relat Res 1999;(367 Suppl):239-43.
• Gross AE. Repair of cartilage defects in the knee. J Knee Surg 2002;15:167-9.
• Shapiro F, Koide S, Glimcher MJ. Cell origin and differentiation in the repair of full-thickness defects of articular cartilage. J Bone Joint Surg Am 1993;75:532-53.
• Buckwalter JA, Lohmander S. Operative treatment of osteoarthrosis. Current practice and future development. J Bone Joint Surg Am 1994;76:1405-18.
• Johnstone B, Yoo JU. Autologous mesenchymal progenitor cells in articular cartilage repair. Clin Orthop Relat Res 1999;(367 Suppl):S156-62.
• Ochi M. Challenging for cartilage repair. Sports Med Arthrosc Rehabil Ther Technol 2009;1:13.
• Fajardo LF. Morphology of radiation effects on normal tissue. In: Perez CA, Brady LW, editors. Principles and practice of radiation oncology. 3rd ed. Philadelphia: Lipincott-Raven; 19 P. 143-54. Shi CM, Su YP, Cheng TM. Recent advances in the pathological basis and experimental management of impaired wound healing due to total-body irradiation. Med Sci Monit 2006;12:RA1-4.
• Takahashi S, Sugimoto M, Kotoura Y, Oka M, Sasai K, Abe M, et al. Long-lasting tolerance of articular cartilage after experimental intraoperative radiation in rabbits. Clin Orthop Relat Res 1992;(275):300-5.
• Eng TY, Boersma MK, Fuller CD, Luh JY, Siddiqi A, Wang S, et al. The role of radiation therapy in benign diseases. Hematol Oncol Clin North Am 2006;20:523-57.
• Wakitani S, Goto T, Pineda SJ, Young RG, Mansour JM, Caplan AI, et al. Mesenchymal cell-based repair of large, full-thickness defects of articular cartilage. J Bone Joint Surg Am 1994;76:579-92.
• Liebmann A, Hindemith M, Jahns J, Madaj-Sterba P, Weisheit S, Kamprad F, et al. Low-dose X-irradiation of adjuvant-induced arthritis in rats. Efficacy of different fractionation schedules. Strahlenther Onkol 2004;180:165-72. Fischer U, Kamprad F, Koch F, Ludewig E, Melzer R, Hildebrandt G. The effects of low-dose Co-60 irradiation on the course of aseptic arthritis in a rabbit knee joint. [Article in German] Strahlenther Onkol 1998;174:633-9.
• Song SU, Hong YJ, Oh IS, Yi Y, Choi KB, Lee JW, et al. Regeneration of hyaline articular cartilage with irradiated transforming growth factor beta1-producing fibroblasts. Tissue Eng 2004;10:665-72.
• O’Driscoll SW, Keeley FW, Salter RB. The chondrogenic potential of free autogenous periosteal grafts for biological resurfacing of major full-thickness defects in joint surfaces under the influence of continuous passive motion. An experimental investigation in the rabbit. J Bone Joint Surg Am 1986;68:1017-35.
• O’Driscoll SW, Keeley FW, Salter RB. Durability of regenerated articular cartilage produced by free autogenous periosteal grafts in major full-thickness defects in joint surfaces under the influence of continuous passive motion. A follow-up report at one year. J Bone Joint Surg Am 1998;70: 595-60
• Mainil-Varlet P, Aigner T, Brittberg M, Bullough P, Hollander A, Hunziker E, et al. Histological assessment of cartilage repair: a report by the Histology Endpoint Committee of the International Cartilage Repair Society (ICRS). J Bone Joint Surg Am 2003;85-A Suppl 2:45-57.
• Hangody L, Feczkó P, Bartha L, Bodó G, Kish G. Mosaicplasty for the treatment of articular defects of the knee and ankle. Clin Orthop Relat Res 2001;(391 Suppl):S328-36.
• Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg Am 2003; 85:185-92.
• Poole AR. What type of cartilage repair are we attempting to attain? J Bone Joint Surg Am 2003;85:40-4.
• Schultze J, Eilf K. Perspectives of radiation therapy in benign diseases. [Article in German] Strahlenther Onkol 2006;182:259-62.
• Takahashi T, Mizobuchi H, Toda M, Maeda A, Mizuno S, Ogawa Y, et al. Metabolic effects of X-ray irradiation on adult human articular chondrocytes. Int J Mol Med 2003;11:631-4.
• Hildebrandt G, Jahns J, Hindemith M, Spranger S, Sack U, Kinne RW, et al. Effects of low dose radiation therapy on adjuvant induced arthritis in rats. Int J Radiat Biol 2000;76:1143-53.
• Hildebrandt G, Radlingmayr A, Rosenthal S, Rothe R, Jahns J, Hindemith M, et al. Low-dose radiotherapy (LD-RT) and the modulation of iNOS expression in adjuvant-induced arthritis in rats. Int J Radiat Biol 2003;79:993-1001.