摘要
背景:使用同种异体移植物进行前交叉韧带重建手术后的腱骨愈合过程复杂,愈合不良易导致隧道扩大。术前移植物的处理过程可能对腱骨愈合存在一定影响,但是具体情况并不清楚。目的:探讨同种异体移植物术前处置方法对韧带重建术后腱骨愈合过程中骨重塑的影响。方法:取32只雄性比格犬,建立双侧后膝前交叉韧带断裂模型后,采用抛硬币法随机分4组进行前交叉韧重建手术:A组以新鲜自体跟腱为移植物,B组以新鲜同种异体跟腱为移植物,C组以γ射线辐照后低温冷藏的同种异体跟腱为移植物,D组以冻干后经γ射线辐照的同种异体跟腱为移植物,每组8只。术后3,6个月取股骨-移植物-胫骨复合体,行Micro CT扫描和组织切片破骨细胞抗酒石酸酸性磷酸酶染色,扫描图像进一步行骨微观结构参数测量,并建立3D骨隧道模型测量隧道面积。结果与结论:(1)Micro CT扫描:术后3个月,D组连接密度、骨小梁数量、骨小梁厚度、骨体积与总体积比值及结构模型指数均低于A、C组(P<0.05),骨小梁分离度高于A组(P<0.05);B组接密度、骨小梁数量及结构模型指数均低于A组(P<0.05),骨小梁分离度高于A组(P<0.05),骨体积与总体积比值低于A、C组(P<0.05)。术后6个月,D组连接密度、骨小梁数量及骨体积与总体积比值均低于A组(P<0.05),骨小梁厚度及结构模型指数均低于A、C组(P<0.05),骨小梁分离度高于A组(P<0.05);B组连接密度、结构模型指数低于A组(P<0.05),骨小梁厚度低于A、C组(P<0.05),骨小梁分离度高于A组(P<0.05);(2)抗酒石酸酸性磷酸酶染色:与A组相比,B、D组破骨细胞染色更深且数量更多;C组破骨细胞在形态和数量上类似于A组,体积偏小且着色偏淡;(3)隧道面积:相同时间点下,D组股骨与胫骨隧道扩大程度最大;B组术后3个月的股骨隧道内口、术后3,6个月的股骨隧道内口与中部面积均大于A组(P<0.05),术后3,6个月�
BACKGROUND:The process of tendon-bone healing after anterior cruciate ligament reconstruction with allografts is complex,and tunnel enlargement may occur due to poor healing.The process of preoperative graft treatment may have some influence on tendon-bone healing,but the specific situation is not clear.OBJECTIVE:To explore the effects of allograft disposal methods on bone remodeling during tendon-bone healing after anterior cruciate ligament reconstruction surgery.METHODS:Thirty-two male beagles were randomly divided into four groups(n=8 per group)for anterior cruciate ligament reconstruction by coin toss method after establishing bilateral posterior cruciate ligament rupture models.In group A,fresh autogenous Achilles tendon grafts were used.In group B,a fresh allograft Achilles tendon was used.In group C,an allograft Achilles tendon irradiated by gamma rays and refrigerated at low temperature was used.In group D,lyophilized allograft tendon afterγ-ray irradiation was used.Micro CT scanning and osteoclast tartrate-resistant acid phosphatase staining were performed in the femor-graft-tibia complex at 3 and 6 months after anterior cruciate ligament reconstruction.Scanning images were selected to measure the bone microstructural parameters and a 3D bone tunnel model was established to measure the tunnel area.RESULTS AND CONCLUSION:(1)Micro CT scan:3 months after operation,the connection density,trabecular number,trabecular thickness,ratio of bone volume to total volume and structural model index in group D were lower than those in groups A and C(P<0.05).The trabecular separation was higher in group D than that of group A(P<0.05).The connection density,trabecular number and structural model index of group B were lower than those of group A(P<0.05).The trabecular separation was higher in group B than that in group A(P<0.05).The ratio of bone volume to total volume was lower in group B than that in groups A and C(P<0.05).Six months after surgery,the connection density,trabecular number and the ratio of bone volume t
作者
尚小可
马占军
温鹏
王浩
马少伟
胡建中
李箭
郑君
李棋
Shang Xiaoke;Ma Zhanjun;Wen Peng;Wang Hao;Ma Shaowei;Hu Jianzhong;Li Jian;Zheng Jun;Li Qi(The First Affiliated Hospital of Northwest Minzu University(People’s Hospital of Ningxia Hui Autonomous Region),Yinchuan 750000,Ningxia Hui Autonomous Region,China;Tongxin County People’s Hospital,Wuzhong 751300,Ningxia Hui Autonomous Region,China;The Third Clinical Medical College of Ningxia Medical University,Yinchuan 750000,Ningxia Hui Autonomous Region,China;Xiangya Hospital of Central South University,Changsha 410000,Hunan Province,China;West China Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2023年第34期5516-5522,共7页
Chinese Journal of Tissue Engineering Research
基金
西北民族大学中央高校基本科研业务费项目(青年教师创新项目)(31920210045),项目负责人:尚小可
宁夏自然科学基金项目(2020A0534),项目负责人:尚小可。
关键词
前交叉韧带重建
同种异体移植物
跟腱
处置方法
腱骨愈合
骨重塑
anterior cruciate ligament reconstruction
allograft
Achilles tendon
disposal method
tendon-bone healing
bone remodeling
