Tavşanlarda kondral defektlerin tedavisinde insan amniyotik sıvısı ile insan amniyotik membranının ayrı ayrı ve birlikte kullanımının etkileri (deneysel çalışma)
The effects of human amniotic fluid injection, human amniotic membrane wrapping and combined application of both on chondral defects in rabbits (an experimental study)
- Tez No: 163516
- Danışmanlar: PROF.DR. OSMAN KARAOĞLAN
- Tez Türü: Tıpta Uzmanlık
- Konular: Ortopedi ve Travmatoloji, Orthopedics and Traumatology
- Anahtar Kelimeler: Chondral defect, human amniotic fluid, human amniotic membrane, Modified O'Driscoll Grading Scale
- Yıl: 2005
- Dil: Türkçe
- Üniversite: Dokuz Eylül Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Ortopedi ve Travmatoloji Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
l.OZET Tavşanlarda Kondral Defektlerin Tedavisinde, İnsan Amniyotik Sıvısı İle İnsan Amniyotik Membranının Ayn Ayrı Ve Birlikte Kullanımının Etkileri (Deneysel Çalışma ) Dr.îsmail Safa SATOĞLU Dokuz Eylül Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı Balçova-İZMİR Eklem hyalin kıkırdak defektleri ortopedi pratiğinde en sık karşılaşılan yaralanmalardandır. Hyalin kıkırdak dokusunun, intrinsik iyileşme kapasitesi açısından yetersiz olması nedeniyle, uygulanmakta olan tedavilerin çoğu başarısız olmakta ve erken osteoartrit gelişimi ile sonlanmaktadır. Çalışmamızda; tavşanlarda oluşturulan kondral defektlerin insan amniyotik sıvısı, insan amniyotik membranı ve her Msinin birlikte uygulanması ile tedavi edilmesi ve tedavilerin birbirleri ile farklarının incelenmesi amaçlanmıştır. Klinik ve hayvan etik kurul onayları alındıktan sonra ağırlıkları ortalama 1600-1800 gr arasında değişen, normal aktiviteye sahip, immatür Albino tipi 32 Yeni Zelanda tavşanın 64 dizi çalışmaya alındı. Cerrahi müdahale ile diz eklemlerinde, medial femoral kondillerin yük alan bölgelerinde, 3mm genişliğinde, 7mm uzunluğunda kondral defektler oluşturuldu. Eklemler; defekt oluşturulmasını takiben tedavi uygulanmayanlar (kontrol grubu /grup 1), insan amniyotik sıvısı uygulananlar (grup 2), insan amniyotik membranı uygulananlar (grup3) ve insan amniyotik sıvısı ile membranı birlikte uygulananlar (grup 4) olmak üzere dört gruba ayrıldı. Diz ehemlerinin bir kısmı (n=36) dördüncü haftada (erken dönem), diğer kısmı (n=28) ise 12.haftada (orta dönem) histopatolojik olarak Modifiye O'Driscoll Skorlama Sistemi ile puanlandı. Bulgular, Mann Whitney U ve ANOVA testleri ile istatistiksel olarak değerlendirildi.2.ABSTRACT The Effects Of Human Amniotic Fluid Injection, Human Amniotic Membrane Wrapping and Combined Application of Both On Chondral Defects In Rabbits (An Experimental Study) Ismail Safa Satoglu,MD Dokuz Eylul University, School of Medicine Department of Orthopedics and Traumatology Izmir,Turkey Articular hyaline cartilage defects are among the most common injuries encountered in orthopedic practice. Depending on the limited intrinsic repair capacity of the articular cartilage, most of the treatment regimes do not achieve reliable regrowth of normal hyaline cartilage; resulting in early development of osteoarthritis. The purpose of this study was to determine the effects of human amniotic fluid injection, human amniotic membrane wrapping and combined application of both techniques on chondral defects in rabbits. 64 knees of 32 immature Albino New Zealand rabbits weighing between 1600-1800 grs. were included in the study following approval of both Animal Experimental and Clinical Experimental Ethics Committee. Chondral defects of 3 mm width and 7 mm length were created surgically in the weight bearing surface of the medial condyles of the rabbits. The samples were divided into four groups. The first group was left untreated after creating the defect (group 1/control), human amniotic fluid was injected to the second group (group 2), human amniotic membrane was wrapped around the defect in the third group (group 3) and in the fourth group amniotic fluid injection and amniotic membrane wrapping (group 4) was administered. Some of the knee condyles (n=36) were scored histopathologically at 4th week (early results) and the rest (n=28) at 12th week (midterm results) using the Modified O'Driscoll Grading Scale. The results were statistically analyzed by Mann Whitney U and ANOVA tests. There were no significant differences in the quality of the regenerated tissue within and between groups (p>0.05). The mean results of the sample group at the 12th week were
Özet (Çeviri)
2.ABSTRACT The Effects Of Human Amniotic Fluid Injection, Human Amniotic Membrane Wrapping and Combined Application of Both On Chondral Defects In Rabbits (An Experimental Study) Ismail Safa Satoglu,MD Dokuz Eylul University, School of Medicine Department of Orthopedics and Traumatology Izmir,Turkey Articular hyaline cartilage defects are among the most common injuries encountered in orthopedic practice. Depending on the limited intrinsic repair capacity of the articular cartilage, most of the treatment regimes do not achieve reliable regrowth of normal hyaline cartilage; resulting in early development of osteoarthritis. The purpose of this study was to determine the effects of human amniotic fluid injection, human amniotic membrane wrapping and combined application of both techniques on chondral defects in rabbits. 64 knees of 32 immature Albino New Zealand rabbits weighing between 1600-1800 grs. were included in the study following approval of both Animal Experimental and Clinical Experimental Ethics Committee. Chondral defects of 3 mm width and 7 mm length were created surgically in the weight bearing surface of the medial condyles of the rabbits. The samples were divided into four groups. The first group was left untreated after creating the defect (group 1/control), human amniotic fluid was injected to the second group (group 2), human amniotic membrane was wrapped around the defect in the third group (group 3) and in the fourth group amniotic fluid injection and amniotic membrane wrapping (group 4) was administered. Some of the knee condyles (n=36) were scored histopathologically at 4th week (early results) and the rest (n=28) at 12th week (midterm results) using the Modified O'Driscoll Grading Scale. The results were statistically analyzed by Mann Whitney U and ANOVA tests. There were no significant differences in the quality of the regenerated tissue within and between groups (p>0.05). The mean results of the sample group at the 12th week wereworse than the 4th week; however, the difference was statistically significant for only the control group (group 1) and the group having received combined therapy (group 4). (respectively; p=0.007, p=0.014). We conclude that human amniotic fluid injection, human amniotic membrane wrapping and combined application of both neither affects chondral defect healing in rabbits nor has any difference between each other. Nevertheless; having better results at 4th week, we believe that some regeneration caused by intrinsic repair mechanism, is possible in immature rabbits although it is prone to degeneration in long term follow up. This degeneration can be attributed to the mechanical quality of the regenerated tissue which remains inferior to normal hyaline cartilage. We suggest that a larger sample of individual treatments with human amniotic fluid, human amniotic membrane or both would probably display a statistically significant difference.
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