急性期兔前交叉韧带保残重建的组织学研究  

Histological study of acute anterior cruciate ligament reconstruction with remnant preservation in rabbits

作　　者：黎广平[1] 陈大福[1] 刘宝岳[2] 

机构地区：[1]北京积水潭医院北京市创伤骨科研究所,北京100035 [2]北京积水潭医院病理科,北京100035

出　　处：《中国医药导报》2016年第1期30-34,共5页China Medical Herald

摘　　要：目的应用动物模型评估急性期保留残端对兔前交叉韧带(ACL)重建的组织学意义。方法选取20只成年健康的新西兰兔,利用其一侧后肢塑造急性期ACL断裂模型,然后将所有动物随机分为两组,每组各10只。一组采用保留残存腱束的方法重建ACL(保残组),另一组采用去除残存腱束的方法重建ACL(去残组)。所有动物统一采用自体半腱肌腱作为移植物,并在术后12周统一处死。首先利用肉眼对韧带的宏观状态进行观察,然后利用HE染色评估残端与移植物愈合情况,并利用免疫组化染色评估移植物本体感受器及血运重建恢复情况。结果大体观察结果显示,所有ACL移植物连续性完整,张力满意。HE染色评估显示残端及移植物未见明显愈合迹象。免疫组化结果显示两组标本移植物本体感受器数量(P=0.564)及新生血管数量(P=0.783)差异无统计学意义。结论急性期保残重建ACL未能显著提高兔ACL重建的组织学性能。本研究中,组织学评估显示ACL残端与移植物间未能愈合,且两组移植物中新生神经本体感受器与新生血管数量未见显著差异。因此,保留残端重建ACL的组织学意义令人质疑。Objective To evaluate the potential histological benefits after the acute remnant-preserving anterior cruciate ligament（ACL） reconstruction in rabbit model.Methods 20 mature female New Zealand white rabbits were selected for acute ACL femoral detachment model in one of the hind limbs,they were randomly divided into two groups,with 10 rabbits in each group.Remnant-preserving group were treated with remnant-preserving ACL reconstruction,conventional remnant group were treated with conventional ACL reconstruction.All the surgeries used the semitendinosus tendon autografts,and all the animals were sacrificed at 12 weeks after surgery for macroscopic observations.The remnant-to-graft healing capacity was evaluated using HE staining method,the immonuhistochemical staining was used to assess the reinnervation and revascularity of the ACL grafts between groups.Results Macroscopic observations revealed that all the ACL grafts maintained adequate continuity and tension.Histological evaluations showed that satisfied tendon-to-bone healing results in each specimen.However,none of the specimen showed a remnant-to-graft healing results.Moreover,the reinnervation（P=0.564） and revascularity（P=0.783） of ACL grafts still showed no statistically significant differences between two groups.Conclusion The acute remnant-preserving ACL reconstruction fail to significantly improve the histological properties compared with the conventional ACL reconstruction.In this study,no remnant-to-graft healing capacity shows on HE staining and no significant differences detecte between groups in terms of reinnervation and revascularity of the ACL grafts.The histological benefit of remnant-preserving ACL reconstruction is therefore questioned.

关 键 词：前交叉韧带 保留残端 组织学 兔 

分 类 号：R318.01[医药卫生—生物医学工程]