后交叉韧带重建移植物的拉伸力学研究  

Study on the tensile mechanics of posterior cruciate ligament reconstruction in grafts

作　　者：张冉[1] 秦小勇[1] 陈凯[1] 胡晓东 Zhang Yan;Qin Xiaoyong;Chen Kai;Hu Xiaodong(Department of Orthopedics,Liuzhou General Hospital,Liuzhou 545006,China)

机构地区：[1]广西柳州市人民医院骨科,柳州545006

出　　处：《广西医科大学学报》2018年第8期1054-1058,共5页Journal of Guangxi Medical University

基　　金：广西柳州市科技计划课题资助项目(No.2015J030524)

摘　　要：目的:检测后交叉韧带重建移植物的拉伸力学参数,为新型的后交叉韧带重建方法提供生物力学参考。方法:将24只比格犬切断双后肢膝关节后交叉韧带,以拇趾长屈肌肌腱为移植物重建后交叉韧带,其中一侧用跟腱腱周组织包绕移植物为实验组,对侧不做包绕作为对照组,术后第4、第8、第12周分别各取8只犬的膝关节,膝关节稳定结构只保留重建后交叉韧带的移植物,在电子万能实验机行拉伸实验,直至拉断;然后取出重建的移植物行Ⅰ型、Ⅲ型胶原蛋白免疫组化检查。结果:实验组移植物术后第4周大量血管增生,第4、第8、第12周纤维细胞增殖,Ⅰ型、Ⅲ型胶原分布于纤维细胞周围,术后第4、第8周Ⅲ型胶原分布多于Ⅰ型胶原,术后第12周Ⅰ型胶原多于Ⅲ型胶原;对照组移植物各时段有少量纤维细胞增生,细胞排列不规律,随时间推移纤维细胞依次增多,各个时段在增殖纤维细胞周围均有Ⅲ型胶原表达,术后第12周可见少量Ⅰ型胶原平行排列于增殖纤维细胞。力学拉伸实验中,术后实验组移植物长度短于对照组(P<0.05),除第12周拉伸长度对比无差异(P>0.05)外,实验组移植物横截面积、最大拉伸载荷、最大应变、弹性模量均大于对照组(均P<0.05)。结论:腱周组织包绕移植物重建后交叉韧带可加快纤维细胞迁移、增殖,提高移植物横截面积、最大拉伸载荷、最大应变、弹性模量,可作为新型的后交叉韧带的重建方法。Objective：To examine the mechanical tensile parameters and molecular biological characteristics of a novel posterior cruciate ligament（PCL）reconstruction in a dog model in order to provide a biomechanical reference for the application of this reconstruction in clinical practice.Methods：PCL was reconstructed with flexor hallucis longus（FHL）wrapping the peritendon tissues of Achilles tendons in 24 Beagle dogs（experimental group）and with simple tendon autograft（control group）.After 4,8 and 12 weeks,we retained the graft of the knee joint stable structure.This knee structure was stretched in auniversal electronic machine.The experiment was continued until the reconstructed ligaments were broken.The type I and typeⅢ collagen expressions in the reconstructed ligaments were detected by immunohistochemistry.Results：In the experimental group,a large number of blood vessels proliferated at 4 weeks after transplantation,and fibroblasts proliferated at 4,8 and 12 weeks.Collagen types I and Ⅲ were seen around fibrocytes.The amount of typeⅢ procollagen was more than that of type I collagen before 8 weeks.In comparison,in the control group,there was a smaller amount of fibroblasts proliferated at each stages.The cells were arranged irregularly,and the fibrocytes increased with time prolonged.Type Ⅲ Collagen was expressed around the proliferating fibroblasts at each time point.At 12 weeks after operation,a small amount of type I collagen was arranged parallel to the proliferating fibroblasts.In the mechanical tensile test,the length of the graft in the experimental group was shorter than that in the control group（P〈0.05）.There was no difference in length at the 12 th week（P〉0.05）.Implant length of the experimental group was shorter,and the cross-sectional area,the maximum tensile load,the maximum strain and elastic modulus were higher than those in the control group（P〈0.05）.Conclusion：In a dog model,wrapping the reconstructed PCL using peritendon tissues facilitated the migration

关 键 词：后交叉韧带重建移植物 胶原纤维 免疫组化 弹性模量 

分 类 号：R687.4[医药卫生—骨科学]