术后早期关节腔冲洗对兔前交叉韧带重建后腱-骨愈合的影响  

Effect of early intra-articular irrigation on tendon-bone healing after reconstruction of the anterior cruciate ligament in rabbits

作　　者：董向辉[1] 徐翠香[2] 孙正明[1] 常彦海[1] 凌鸣[1] DONG Xianghui;XU Cuixiang;SUN Zhengming;CHANG Yanhai;LING Ming(Department of Orthopedics, People＇ s Hospital of Shaanxi Province , Xi ＇ an 710068, China;Shaanxi Provincial Center for Clinical Laboratory)

机构地区：[1]陕西省人民医院骨科,西安710068 [2]陕西省临床检验中心

出　　处：《山西医科大学学报》2018年第5期488-491,共4页Journal of Shanxi Medical University

基　　金：陕西省自然科学基础研究计划项目(2011JM4050)

摘　　要：目的研究术后早期关节腔冲洗对兔前交叉韧带(anterior cruciate ligament,ACL)重建后腱-骨愈合的影响。方法用24只8-10月新西兰白兔双侧踇长伸肌腱建立前交叉韧带重建模型,随机选其一侧后肢作为实验组,对侧作为对照组。实验组在重建术后5 d内定期(每日一次,上午9点,直至冲洗液清亮为止)进行关节腔内冲洗,对照组不做处理。于术后4周、8周、12周分别处死8只,观察术后腱-骨愈合部位组织学变化,并测定腱-骨界面成纤维细胞数目。结果术后4周、8周、12周组织学观察:ACL重建术后实验组和对照组腱-骨界面成纤维细胞数量均逐渐增加,在第8周末最多,后逐渐下降,但对照组下降更为明显。实验组腱-骨界面在各个时间点成纤维细胞计数和成骨反应明显优于对照组,差异具有统计学意义(P<0.05)。结论通过早期关节腔冲洗法可改善前交叉韧带重建后关节腔内环境,促进腱骨界面胶原纤维形成,从而促进腱骨愈合。Objective To explore the effects of early intra-articular irrigation on tendon-bone healing after reconstruction of the anterior cruciate ligament（ ACL）. Methods Twenty-four 8-10-month-old New Zealand white rabbits were selected to establish the model of ACL reconstruction using bilateral extensor pollicis longus tendon. One side of hind leg was chosen randomly as experimental group,and its contralateral side was chosen as control group. The legs in experimental group were given regular intra-articular irrigation once a day for 5 d after ACL reconstruction. The legs in control group were only ACL reconstruction,without further treatment. All animals were executed at weeks 4,8,12 after operation to observe histological changes and determine the number of fibroblasts of tendon-bone healing interface. Results After ACL reconstruction,the number of fibroblast cells at tendon-bone interface increased gradually in both groups,and peaked at the eighth weekend,but the tendency of decrease was more significantly in control group. The tendon-bone interface fibroblasts forming and ossification reaction was better in experimental group than in control group at each time point（ P〈0. 05）. Conclusion Early intra-articular irrigation can promote the tendon-bone healing by improving the joint cavity environment after anterior cruciate ligament reconstruction,and promoting the collagen fiber formation of tendon-bone interface.

关 键 词：关节腔冲洗 前交叉韧带 踇长伸肌腱 腱-骨愈合 新西兰白兔 

分 类 号：R687.2[医药卫生—骨科学]