摘要
目的探讨自体骨膜移植对前交叉韧带（ACL）损伤的修复效果。方法选择27只大白兔建立ACL横断损伤模型，按照手术方式分为实验组（自体骨膜移植＋缝合固定，12只）、对照组（单纯缝合固定治疗，12只）和空白对照组（仅行关节切开术，3只）。术后12周取大体标本并利用Markin评分观察和评价ACL损伤愈合、膝关节退变情况。采用HE染色、Masson染色、苦味酸一天狼猩红染色检测ACL组织病理改变、胶原纤维形成及止点结构变化等情况。结果术后12周大体观察可见实验组ACL外观连续、膝关节轻度退变，对照组ACL形成残迹、膝关节退变严重。膝关节退变Markin评分实验组为（7．2±1．6）分、对照组为（12．4±1．8）分，空白组为（0．6±0．4）分，三组间差异有统计学意义（P〈0．05）。HE染色和Masson染色结果显示，实验组ACL损伤修复组织内大量胶原纤维形成，微小血管及细胞浸润，韧带表面覆盖增生的滑膜组织；对照组未见ACL组织修复，形成韧带残迹，纤维松散、排列紊乱，大量微小血管及细胞浸润，游离断端被滑膜组织包裹。HE和苦味酸一天狼猩红染色检测结果显示，实验组ACL止点四层结构完整；对照组ACL止点结构紊乱、“潮线”消失。结论自体骨膜组织能促进ACL损伤修复愈合，减轻关节退变。
Objective To investigate effect of autologous periosteum transplantation in the repair of anterior crueiate ligament （ACL） injury. Methods Transected ACL injury was induced in 24 white rabbits randomly allocated to receive autologous periosteum transplantation with suture fixation （study group, n = 12）, isolated suture fixation （control group, n = 12）, and arthrotomy （blank group, n = 3 ）. Gross observation of ACL repair was performed and degeneration of knee joint was evaluated using the Markin score. ACL pathology, collagen fiber formation and insertion degenerative changes were histologically investigated using the HE staining, Masson staining and Picric-Sirius red staining. Results Twelve weeks after the operation, gross observation showed ligamentous continuity and minor joint degeneration in study group. Opposite results were seen in control group. Markin joint degeneration score calculated 7.2 ＋- 1. 6 in study group, 12.4 ＋- 1. 8 in control group and 0. 6 ＋- 0.4 in blank group, with significant differences between groups （ P 〈 0.05 ）. Using the HE and Masson staining in study group, rich collagen fibers and microvessel as well as cell infiltration were found in wound tissue and the ligaments were covered with synovial membrane. However, wound tissue did not heal in control group, leaving ligament remnants with loosely disorganized fibers and rich microvessel as well as cell infiltration. And only the residual stump was wrapped with synovial membrane. Using the HE and Picric-Sirius red staining, the typical four-layer structure of ACL insertion remained intact in study group, whereas in control group the layer structure of ACL insertion in control group became disorganized and the ＂tidemark＂ of enthesis almost disappeared. Conclusion Autologous periosteum transplantation is effective to improve the injury healing and mitigate the degeneration of joint. [ Key words] Anterior cruciate ligament; Transplantation ; Autogenous periosteum
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2015年第12期1130-1134,共5页
Chinese Journal of Trauma
基金
中国博士后科学基金资助项目（2013M532177）
山东省自然科学基金资助项目（ZR2013HM010）
关键词
前交叉韧带
移植
自体骨膜
Anterior cruciate ligament
Transplantation
Autogenous periosteum
