保留残端纤维与剩余束重建前交叉韧带的实验研究  

AN EXPERIMENTAL STUDY ON ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH REMNANTS AND REMAINING BUNDLE PRESERVATION

作　　者：李志超[1] 刘玉杰[1] 石斌[1] 邬晓勇[1] 朱娟丽[1] 王志刚[1] 李众利[1] 

机构地区：[1]解放军总医院骨科医院,北京100853

出　　处：《中国修复重建外科杂志》2009年第3期282-286,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家科技支撑计划资助项目(2007BA104B00)~~

摘　　要：目的探讨前交叉韧带(anterior cruciate ligament,ACL)损伤重建时保留残端纤维与剩余束对移植肌腱转归的影响。方法2～3月龄健康新西兰大白兔18只,随机分为3组(n=6)。暴露双侧ACL后,清理残端纤维组(A组)完全切断ACL,射频清理胫骨止点残端纤维;保留残端纤维组(B组)完全切断ACL,但不清理止点残端纤维及滑膜;保留剩余束重建组(C组)纵行切除1/2ACL,保留残端纤维。各组均采用同侧长约2.5cm的趾长伸肌腱移植重建韧带。术后观察动物一般情况,于2、4、8周行血管墨汁灌注及HE染色观察,测量新生血管面积及成纤维细胞计数。结果术后观察期内各组实验动物一般情况良好,双膝关节功能良好。术后2、4周,A、B组移植物无新生血管形成,C组移植物表面滑膜内可见新生血管形成,C组新生血管面积分别为(505±27)及(624±23)像素;8周,3组移植物表面均可见新生血管,A、B、C组新生血管面积分别为(674±65)、(836±76)及(1219±146)像素;组间差异有统计学意义(P<0.05)。术后2、4周B组移植物成纤维细胞较A组多(P<0.05),8周时两组差异无统计学意义(P>0.05)。术后各时间点C组成纤维细胞计数均多于A组(P<0.05);术后2、4周C组与B组比较,差异有统计学意义(P<0.05),8周时差异无统计学意义(P>0.05)。结论保留残端纤维与剩余束重建ACL有利于移植肌腱早期建立血运、再血管化及成纤维细胞的增殖,可缩短其缺血时间,有助于新生组织爬行替代和塑形改建。Objective To investigate whether anterior cruciate ligament （ACL） reconstruction with the remnants and the remaining bundle preservation is bene cial for the revascularization of the graft or not. Methods Animal models of the ACL reconstruction in 18 healthy New Zealand White rabbits （2-3 months old） were made using about 2.5 cm long extensor digitorum longus tendon and randomly divided into three groups （n=6）： remnants debridement group （group A）,remnants preservation group （group B） and remaining bundle preservation group （group C）. The histological examination was made after 2,4 and 8 weeks of operation. The intravascular injection of ink was used to observe the revascularization of the graft. The specimens were stained with HE method to observe the histological changes of the graft. Results All the animals were in good condition and had good knee functions in the observation period. There was no new vessel in groups A and B at 2 and 4 weeks postoperatively. And new vessels were observed in the synovium of the graft in group C. The areas of the vessels in group C were （505 ± 27） pixels at 2 weeks and （624 ± 23） pixels at 4 weeks. At 8 weeks postoperatively new vessels were observed in all the three groups. The new vessel areas of groups A,B and C were （674 ± 65）,（836 ± 76） and （1 219 ± 146） pixels,respectively. The vessel areas of group C were signi cantly bigger than those of groups A and B （P 〈 0.05）. The vessel area of group B was signi cantly bigger than that of group A （P 〈 0.05）. The broblast amount in group B was signi cantly more than that in group A at 2 and 4 weeks postoperatively （P 〈 0.05）. But there was no signi cant di erence between them at 8 weeks postoperatively （P 〉 0.05）. The broblast amount of group C was signi cantly more than that of group A （P 〈 0.05） at each observation time postoperatively. At 2 and 4 weeks postoperatively,the broblast amount of group C was signi cantly more than that of group B （P 〈 0

关 键 词：前交叉韧带 重建 残端纤维 剩余束 兔 

分 类 号：R687.2[医药卫生—骨科学]