摘要
目的探讨并比较两种移植物重建前交叉韧带(anterior cruciate ligament,ACL)后早期移植物隧道界面愈合的生物学机制。方法55只成年新西兰大白兔,体重2.0～2.8kg。左膝关节切取带胫骨-骨块的髌韧带作为供区,右膝关节作为自体移植重建ACL受区。移植物骨块端为骨-骨界面愈合模型,韧带端为腱-骨界面愈合模型。术后观察实验动物一般情况,术后第2、4和8周取材(n=5)行大体及组织学观察,并于第4、8周取材(n=20)进行生物力学检测。结果术后动物肢体活动情况良好,实验过程中ACL连续性完整,张力适中。组织学观察:术后2周骨-骨界面大部分区域为纤维组织连接,腱-骨界面主要为肉芽组织填充;术后4周骨-骨界面大部分区域骨性愈合,腱-骨界面可见成骨反应及大量成纤维细胞;术后8周骨-骨界面已完全骨性愈合,腱-骨界面部分区域可见Sharpey纤维,形成间接止点。生物力学观察:术后4周腱-骨界面拔出率为85%,骨-骨界面为15%;术后8周腱-骨界面拔出率为95%,骨-骨界面为5%;各时间点骨-骨界面拔出率与腱-骨界面拔出率比较差异均有统计学意义(P<0.001)。结论ACL重建术后早期骨-骨界面较腱-骨界面在愈合强度和速度上具有优势。
Objective To investigate and compare the difference between two implants of reconstructing anterior cruciate l igament （ACL） for the early heal ing of implants tunnel interface in terms of biological mechanism. Methods Fiftyfive adult New Zealand rabbits weighing 2.0-2.8 kg were selected. Patellar l igament with tibia-bone block was obtained from the left knee joint serving as donor site, right knee joint served as the recipient site of autograft for ACL reconstruction. The bone block end of implant was bone-bone interface heal ing model, while the l igament end was tendon-bone interface heal ing model. The general condition of rabbits was observed after operation, the gross observation and histology observation were conducted at 2, 4 and 8 weeks after operation （n=5）, and biomechanics examination was conducted at 4 and 8 weeks after operation （n=20）. Results Rabbits behaved normally after operation. The gross observation indicated that ACL had complete continuity and moderate tension during experiment. Histology observation： most part of bone-bone interface was connected by fibrous tissue, while the tendon-bone interface was mainly filled by granulation tissue 2 weeks after operation; most part of bone-bone interface was bone union, and there were osteogenesis reaction and large quantity of fibroblasts in the tendonbone interface 4 weeks after operation; complete bone union was evident in bone-bone interface, and the appearance of Sharpey fibers and the formation of indirect insertion occured in part of tendon-bone interface 8 weeks after operation. Biomechanics observation： the pull-out rate for tendon-bone interface and bone-bone interface 4 weeks after operation was 85% and 15%, respectively; while it was 95% and 5% 8 weeks after operation, respectively; indicating there was a significant difference between two groups （P 〈 0.001）. Conclusion In the early stage after ACL reconstruction, bone-bone interface is better than tendonbone interface in terms of intensity and speed of heal ing.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2009年第4期473-477,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
前交叉韧带
重建
腱-骨愈合
骨-骨愈合
兔
Anterior cruciate ligament Reconstruction Tendon-bone healing Bone-bonehealing Rabbit
