摘要
目的探讨带肌腹血供的腓骨长肌腱移植重建前交叉韧带(anterior cruciate ligament,ACL)对止点转归的影响。方法将80只健康新西兰大白兔随机分成两组(n=40),制备ACL损伤模型后,分别采用带肌腹血供(A组)和不带肌腹血供(B组)的自体腓骨长肌腱重建ACL。术后观察动物存活及切口愈合等一般情况;4、8、16周取材行大体及组织学观察;8、16周行移植物生物力学测试,记录最大抗拉强度及ACL止点断裂率。结果两组动物均存活至实验完成。大体观察示重建术后随时间延长,A组骨隧道与移植物紧密结合,血管浸润丰富,至16周时已无明显分界;而B组腱-骨间仍存在明显分界。组织学观察显示,A组腱-骨之间胶原纤维逐渐增多,形成致密纤维连接,至16周时形成类似正常ACL止点的"潮线"结构;而B组结构不明显。生物力学测试显示,术后8、16周A、B组ACL止点断裂率比较,差异均无统计学意义(P=0.680;P=0.590);但A组最大抗拉强度显著优于B组,差异均有统计学意义(t=18.503,P=0.001;t=25.391,P=0.001)。结论带肌腹血供的腓骨长肌腱移植重建兔ACL对其止点转归具有明显促进作用,进而提高重建效果。
Objective To investigate the effect of vascularized peroneus longus tendon graft reconstruction on anterior cruciate ligament(ACL)insertion in rabbits.Methods Eighty healthy New Zealand white rabbits were harvested to prepare ACL injury models and randomly divided into two groups(n=40).The ACL was reconstructed with vascularized peroneus longus tendon graft in group A and peroneus longus tendon graft without blood supply in group B.The survival of animals and the healing of incision were observed after operation;the grafts were taken for gross and histological observations at 4,8,and 16 weeks;the biomechanical test of the grafts was carried out to record the maximum tensile strength and incidence of ACL insertion rupture at 8 and 16 weeks.Results All animals survived until the experiment completed.General observation showed that the tunnel was combined with grafts,the vascular infiltration was abundant,and no obvious boundary between the tunnel and grafts existed at 16 weeks in group A;there was still an obvious boundary between the tunnel and graft in group B.Histological observation showed that the collagen fibers between tendon and bone in group A increased gradually,the dense fiber connection was formed,and the"tidal-line"like structure similar to the normal ACL insertion was formed at 16 weeks;but the"tidal-line"like structure was not obvious in group B.Biomechanical test showed that there was no significant difference in the incidence of ACL insertion rupture at 8 and 16 weeks between group A and group B(P=0.680;P=0.590),but the maximum tensile strength at 8 and 16 weeks were higher in group A than in group B(t=18.503,P=0.001;t=25.391,P=0.001).Conclusion The vascularized peroneus longus tendon graft for ACL reconstruction can obviously promote the outcome of the ACL insertion.
作者
张培
刘泉
樊宗庆
吴敏
朱坤
周建生
项平
ZHANG Pei;LIU Quan;FAN Zongqing;WU Min;ZHU Kun;ZHOU Jiansheng;XIANG Ping(Department of Orthopaedics,the First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui,233000,P.R.China;Key Laboratory of Tissue and Transplant in Anhui Province,the First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui,233000,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2020年第7期848-853,共6页
Chinese Journal of Reparative and Reconstructive Surgery
基金
安徽省高校省级自然科学研究重点项目(KJ2016A870)
蚌埠医学院青年科研基金项目(BY0850)。
关键词
前交叉韧带
腓骨长肌腱
韧带重建
血供
韧带止点
兔
Anterior cruciate ligament
peroneus longus tendon
ligament reconstruction
blood supply
ligament insertion
rabbit
