兔同种异体半月板移植后膝胫股关节面生物力学重建的研究  

BIOMECHANICAL RECONSTRUCTION OF TIBIOFEMORAL CONTACT AREA AFTER MENISCAL ALLOGRAFT IN RABBITS

作　　者：薛超[1] 罗殿中[1] 衷鸿宾[1] 张轶超[1] 章亚东[1] 侯树勋[1] 

机构地区：[1]解放军总医院第一附属医院骨科,北京100048

出　　处：《中国修复重建外科杂志》2011年第4期397-401,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：首都医学发展基金资助项目(20073044)~~

摘　　要：目的探讨兔同种异体半月板移植后膝关节内侧间隙受力面积、压强的变化及其生物力学重建情况。方法 6～7月龄清洁级日本大耳白兔28只,雌雄不限,体重3.0～3.5kg;随机取7只兔右膝关节内侧半月板,制备同种异体半月板。余21只兔随机分为3组,每组7只。A组为空白对照组,单纯打开膝关节后缝合;B组为右膝内侧半月板切除组;C组为右膝内侧半月板切除后行同种异体半月板移植组。术后观察各组实验动物一般情况,于12周处死实验动物取右膝关节行生物力学测试,并取A、C组半月板行组织学及免疫组织化学染色观察。结果术后实验动物均存活至实验完成。术后12周大体观察见C组移植半月板愈合较好,前后角及体部附着良好。术后12周膝关节屈膝0、30、60、90°时,B组膝关节内侧间隙受力面积及压强与A、C组比较,差异均有统计学意义(P<0.05),A、C组间比较差异均无统计学意义(P>0.05);屈膝120°时,任意两组间受力面积及压强比较,差异均有统计学意义(P<0.05)。组织学观察显示C组软骨细胞及胶原纤维数量恢复正常;免疫组织化学染色示C组移植半月板内胶原纤维含有大量Ⅰ型胶原和Ⅱ型胶原。术后12周A、C组Ⅰ型胶原含量分别为0.6125±0.0598和0.5872±0.0639,差异无统计学意义(t=0.765,P=0.465);Ⅱ型胶原含量分别为0.7724±0.0815和0.8143±0.0517,差异无统计学意义(t=—0.136,P=0.894)。结论兔同种异体半月板移植可增加膝关节受力面积,减小压强,有利于保护关节软骨,并可重建生物力学平衡。Objective To observe the changes of force bearing area and pressures of the rabbit tibiofemoral contact area and the biomechanical reconstruction level of joint after meniscal allograft.Methods A total of 28 Japanese rabbits were involved,weighing 3.0-3.5 kg,male or female.Of 28 rabbits,7 were selected as meniscus donors,the remaining 21 rabbits were randomized into group A（n=7）,group B（n=7）,and group C（n=7）.Group A underwent single knee opening and suturing,group B underwent medial meniscus excision and suturing,and group C underwent medial meniscus allograft after medial meniscus excision and suturing.The rabbits were sacrified at 12 weeks after operation for biomechanical observation through biomechanical machine and color imaging system.The meniscus tissue specimens were harvested from groups A and C to perform histological and immunohistochemical staining.Results After operation,all rabbits in 3 groups survived to the end of experiment.There were significant differences in the force bearing area and pressures at 0-90° flexion between group B and groups A,C（P 0.05） at 12 weeks,showing no significant difference between group A and group C（P 0.05）;and there were significant differences in the force bearing area and pressures at 120° flexion among 3 groups（P 0.05）.The histological observation showed that the number of cartilage cells and collagen fibers returned to normal in group C,and the immunohistochemical staining showed that transplanted meniscus of group C contained large amounts of collagen fibers consisting of collagen type I and collagen type II.After 12 weeks of operation,the collagen type I contents were 0.612 5 ± 0.059 8 in group A and 0.587 2 ± 0.063 9 in group C,showing no significant difference（t=0.765,P=0.465）;the collagen type II contents were 0.772 4 ± 0.081 5 and 0.814 3 ± 0.051 7,respectively,showing no significant difference（t= —0.136,P=0.894）.Conclusion The allograft of rabbit meniscus can significantly increase the force bearing area of the tibiofem

关 键 词：同种异体半月板移植 受力面积 压强 生物力学重建 兔 

分 类 号：R687.4[医药卫生—骨科学]