摘要
目的:比较保留与切除残迹前交叉韧带(anterior cruciate ligament,ACL)重建关节内移植物愈合的形态学差异,探讨保留残迹的意义。方法:采用新西兰兔30只,体重(2.62±0.24)kg。切取跟腱制备ACL重建移植物。切断双膝ACL,右膝保留胫骨与股骨端各2 mm残迹(保留残迹组),左膝完全切除两端残迹(切除残迹组)。分别对应ACL残迹或解剖印迹中心建立胫骨与股骨隧道,重建双侧ACL。动物随机分为3组,每组10只,分别于术后4、8、12周,行后肢功能评分、血管灌注大体形态观察和组织学检查。采用SPSS 19.0软件行数据统计学分析。结果:术后4、8、12周,保留残迹组膝关节功能评分均高于切除残迹组,但两组间差异均无统计学意义(P>0.05)。随术后时间延长,保留残迹组可见残迹与移植物愈合、塑型,未见明显"独眼畸形"。术后不同时间点,保留残迹组移植物表面血管密度均高于切除残迹组,4周、8周两组间差异均有统计学意义(P<0.05),但12周两组间差异无统计学意义(P>0.05)。术后不同时间点,保留残迹组关节内移植物细胞增生与组织改建较切除残迹组活跃,保留残迹组的组织学评分高于切除残迹组,4周、8周两组差异均有统计学意义(P<0.05),但12周两组差异无统计学意义(P>0.05)。结论:保留残迹ACL重建的移植物再血管化与移植物组织愈合和塑型优于切除残迹ACL重建,提示临床采用保留残迹技术重建ACL有利于移植物的愈合,加快患者康复。
Objective To explore the significance of remnant preservation in anterior cruciate liga ment（ACL） reconstruction by comparison of morphological differences in intraarticular graft healing with remnant preservation versus remnant resection. Methods Thirty New Zealand rabbits ,weighted 2.62±0.24 kg,were used in this study. The tendon grafts harvested from Achilles tendon were prepared for ACL re construction. As disconnection of ACL in bilateral knees of the animal,the remnant was preserved 2mm on both tibial and femoral ends on the right knee （remnant preservation group）,in contrast,the remnant was removed completely by cauterization on the left knee （remnant resection group）. The tibial and femoral tunnels were created individually on the center of the remnant or anatomic ACL footprints, then the ACLs were reconstructed with the tendon grafts. The animals were divided into three groups at ran dom （ 10 animals in each group）, which were evaluated respectively by functional scoring, gross observa tion with angiography,and histological examination at the 4th,Sth and 12th week after operation. Thedata were analyzed with SPSS 19.0 software. Results At the 4th,8th and 12th week after operation,there were no statistic differences in functional scores between the remnant preservation group and remnant resection group （P 〉 0.05）. As time elapsed,the remnant healed with the graft,and remodeled without remarkable cyclops lesions in remnant preservation gr6up. The vascular density of graft surface were sta tistically higher in the remnant preservation group than that in the remnant resection group at the 4th and 8th week after operation（P 〈 0105）. Additionally, more vigorous proliferation of fibroblast and incor poration of the graft were seen in remnant preservation group. The histological scores in the remnant preservation group were higher than that in the remnant resection group at all the time points. The dif ferences between two groups were statistically significant at 4th and 8th week afte
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2012年第7期577-582,589,共7页
Chinese Journal of Sports Medicine
基金
军队"十一五"医学科技基金(06MB124)
关键词
前交叉韧带重建
残迹
肌腱
愈合
形态学
anterior cruciate ligament reconstruction, remnant, tendon, healing, morphology
