持续被动活动对兔重建前交叉韧带生物力学特性的影响  

Effects of Continuous Passive Motion on Biomechanical Properties of the Tendon Autograft Used for Anterior Cruciate Ligament Reconstruction in a Rabbit Model

作　　者：黄红拾[1] 敖英芳[1] 于运花[2] 曾玮[2] 于文博[3] 

机构地区：[1]北京大学第三医院运动医学研究所,北京100083 [2]北京化工大学材料科学与工程学院,北京100029 [3]北京大学公共卫生学院,北京100083

出　　处：《中国运动医学杂志》2008年第3期283-285,289,共4页Chinese Journal of Sports Medicine

摘　　要：目的:采用半腱肌腱重建兔前交叉韧带(ACL),探讨持续被动活动(CPM)对移植物生物力学特性的影响。方法:对30只8月龄雄性新西兰大白兔右侧后肢膝关节行自体双股半腱肌腱移植重建前交叉韧带手术。术后随机分为CPM组和非CPM组两组:CPM组术后第2天开始采用自制兔膝关节CPM器进行持续被动活动,共6周;非CPM组仅笼养。分别于术后第6、12、24周取材,每组每次取5只行生物力学观察。结果:与非CPM组相比,CPM组大部分标本两束融合成一体。从术后6周到24周,所有移植物的最大载荷、最大应力、弹性模量以及这些指标和其对照侧ACL的比值逐渐增加。在术后6、12、24周时,CPM组移植物最大载荷分别为22.72N、79.56N、122.20N,最大应力分别为4.58MPa、13.62MPa、21.79MPa;非CPM组移植物最大载荷分别为16.00N、70.68N、96.20N,最大应力分别为3.07MPa、11.58MPa、17.89MPa。3个时间点两组间上述指标差异均具有统计学意义(P<0.05)。结论:半腱肌腱重建兔前交叉韧带术后早期进行持续被动活动可明显提高移植物的生物力学性能。Objective To study the effects of continuous passive motion（CPM）on the biomechanical properties of the semitendinous tendon autograft used for anterior cruciate ligament（ACL）reconstruction in rabbits. Methods Thirty rabbits were underwent ACL reconstruction using double semitendinous tendon autograft in right posterior limb knee joint and were treated by either continuous passive motion or cage activity（non-CPM）postoperatively. The biomechanical properties of ACL were tested bilaterally, at 6,12,24 weeks post operation. Results The maxi- mum load,maximum stress and elastic modulus of tendon autograft showed a continuous improving from 6 to 24 weeks in both groups, compared with their own controls. In the CPM specimens, the maximum load of graft was 22.72N,79.56N,122.20N and the maximum stress was 4.58MPa,13.62MPa,21.79MPa in 6,12,24 weeks re- spectively, with statistically significant difference from non-CPM specimens（P〈0.05）. Conclusion Early rehabilitation program with integration of CPM exercise could help the restructuring process of the graft after reconstruction.

关 键 词：兔 前交叉韧带 重建 生物力学 持续被动活动 

分 类 号：R687.2[医药卫生—骨科学] R318.01[医药卫生—外科学]