LARS人工韧带重建前交叉韧带:生物相容性及与骨组织的愈合  

Reconstruction of the anterior cruciate ligament using Ligament Advanced Reinforcement System: its biocompatibility and bone healing

作　　者：翟昕元[1] 林小风[2] Zhai Xin-yuan Lin Xiao-feng(Institute of Physical Education of China Three Gorges University, Yichang 443002, Hubei Province, China Medical School of Yangtze University, Jingzhou 434023, Hubei Province, China)

机构地区：[1]三峡大学体育学院,湖北省宜昌市443002 [2]长江大学医学院,湖北省荆州市434023

出　　处：《中国组织工程研究》2017年第16期2565-2569,共5页Chinese Journal of Tissue Engineering Research

基　　金：湖北省自然科学基金面上项目(2015AFC331)~~

摘　　要：背景:LARS人工韧带能避免传统韧带引起的纤维间摩擦,为自体组织生长提供更多的空间。目的:探讨LARS人工韧带重建交叉韧带的生物相容性及与骨组织的愈合情况。方法:将20只山羊随机分为2组,保留残端组仅切断前交叉韧带股骨止点;切除残端组切除前交叉韧带的股骨、胫骨止点,以及上、下止点间的全部韧带组织与表面滑膜组织,两组均植入LARS人工韧带。植入后20个月,影像学观察韧带修复情况,扫描电镜观察纤维组织情况,组织学观察新生韧带生长情况。结果与结论:(1)影像学检查:CT检查显示,保留残端组股骨隧道扩大数显著高于切除残端组(P<0.05),胫骨隧道扩大数显著低于切除残端组(P<0.05);磁共振检查显示,LARS人工韧带位于股骨及胫骨隧道内和关节游离部分,在磁共振成像下T1、T2加权均为低信号,两组磁共振信号强度相同;(2)扫描电镜观察:两组均在LARS人工韧带之间存在明显的致密纤维组织,LARS人工韧带表面覆盖较多自体组织,高放大倍率下可见LARS人工韧带的自体纤维组织排列紧密、均匀;(3)组织学观察:苏木精-伊红染色显示,两组人工韧带在关节腔内游离部分和骨隧道内被大量自体组织包绕,呈长梭形排列,自体纤维组织整体与人工韧带包绕良好,呈无序排列,骨隧道部分与关节腔内游离部分存在成熟纤维组织,少量毛细血管浸润生长,未见坏死组织。Masson染色显示,两组LARS人工韧带骨隧道内部分和游离部分可见蓝色胶原包绕在人工韧带外部和内部,红染骨组织位于包裹胶原外部,未见明显过渡带;(4)结果表明:LARS人工韧带具备良好的生物相容性和纤维组织诱导能力,可促进骨组织愈合。BACKGROUND： Ligament Advanced Reinforcement Sytstm （LARS） artificial ligament can avoid the interfibrillar friction compared wiht traditional ligaments, which is conductive for autogenous tissue growth. OBJECTIVE： To investigate the biocompatibility of LARS artificial ligament used for cruciate ligament reconstruction and bone healing. METHODS： Twenty goats were randomly divided into two groups： the anterior cruciate ligament insertion at the femur was cut as stump group; the anterior cruciate ligament insertions at the femur and tibia, and all the ligaments and synovial tissues between them were cut as stump resection group. LARS artificial ligament was then implanted into both two groups. At 20 months after implantation, the ligament healing was observed using CT and MRI examinations, the fibrous tissues were observed under scanning electron microscope, and the growth of newborn ligaments was observed by histological staining. RESULTS AND CONCLUSION： CT findings showed that in the stump group, the number of femoral tunnel enlargement was significantly more than that in the stump resection group （P 〈 0.05）, while the number of tibial tunnel enlargement in the stump group was significantly less than that in the stump resection group （P 〈 0.05）. LARS artificial ligament in the femoral and tibial tunnel and free part of the joint presented with hypointensity on T1- and T2-weighted images, which showed no significant difference between two groups. Under the scanning electron microscope there were obvious dense fibrous tissues between LARS artificial ligaments in both two groups; and the autologous fibrous tissues arranged closely and evenly under high magnification. Hematoxylin-eosin staining results showed that in the two groups, the LARS artificial ligaments in the free part of the articular cavity and bone tunnel were surrounded by a large number of autologous tissues in a fusiform arrangement; autologous fibrous tissues and artificial ligament were wrapped well but arranged irregularly;

关 键 词：前交叉韧带 假体和植入物 组织工程 组织构建 LARS人工韧带 重建交叉韧带 生物相容性 骨组织 苏木精-伊红染色 MASSON染色 扫描电镜 诱导能力 湖北省自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]