兔四股半腱肌腱编织重建前交叉韧带的组织学研究  

Histological Study of Four-bundle Hamstring Tendon Autograft Used for Anterior Cruciate Ligament Reconstruction in a Rabbit Model

作　　者：徐雁[1] 敖英芳[1] 于长隆[1] 张继英[1] 傅欣[1] 

机构地区：[1]北京大学第三医院运动医学研究所,北京100083

出　　处：《中国运动医学杂志》2006年第4期381-383,i0001-i0002,共5页Chinese Journal of Sports Medicine

摘　　要：目的:观察并探讨是否可以通过改善等张性的四股肌腱编织方法重建前交叉韧带,促进移植物束间融合。方法:两组新西兰白兔共44只,一组(未编织组)按临床现常规使用的方法行四股平行排列的肌腱移植物重建前交叉韧带作为对照,一组(编织组)行四股肌腱编织后重建前交叉韧带,分别于术后第3周、6周、12周、26周、52周行组织学观察对比。结果:术后第26周与52周,移植物改建塑形基本完成,有些束间结构完全融合,有些虽然融合但组织学有结缔组织相隔,有些仍呈分离的束存在。编织组大体上的融合率显著高于未编织组,组织学变化过程基本类似,但各束肌腱塑形过程比未编织组更同步。结论:通过编织不同束肌腱使之成为一整体重建前交叉韧带可能可以减少不同束之间的相对运动,从而使各束移植物塑形更同步,并促进各束的融合,带来更好的效果。进一步的生物力学方面的研究有待进行。Objective In order to observe the tween single bundles of a four bundles model using histological change of the remodeling process in the gap besemitendinosus tendon for the reconstruction of anterior cruciate ligament in rabbits, to explore the possibility of using braiding technique for improving the outcome for reconstruction of ACL. Methods Two techniques were employed for the ACL reconstruction, the implant in experimental group was braiding bundles rather than the parallel bundles as routine method in control group. Specimens were collected at 3, 6, 12, 26, and 52 weeks after surgery respectively. Gross morphology and his- tological changes were observed, especially in the gap between the bundles. Results At 26 and 52 weeks, the remodeling process in both control and experimental groups was almost completed. Comparing with control group, more gaps were disappeared of filled with connective tissue; however, some gaps were still existed in experiment group. The histological changes in bundle itself were similar in both group, but, more synchronized bundles after braiding the tendon were found in experimental group. Conclusion Braiding each bundle to become a single implant for reconstruction of ACL might have better outcome since it will decrease the movement between each bundles and make the bundles more synchronized. Further investigation will be needed for biomechanical test.

关 键 词：前交叉韧带 重建 胭绳肌腱 编织 组织学 

分 类 号：R687[医药卫生—骨科学]