保留与不保留残端重建前交叉韧带后本体感觉恢复的比较  

Proprioception recovery after anterior cruciate ligament reconstruction with and without remnant preservation

作　　者：柴浩[1] 吴婷 舒莉[1] 张磊 Chai Hao;Wu Ting;Shu Li;Zhang Lei(1First Department of Joint Surgery,Urumqi 830002;Nursing Unit,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002;First Department of Surgery,Hospital Affiliated to Xinjiang Production and Construction Corps of Chinese People’s Armed Police Forces,Urumqi 830061,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第六附属医院关节外一科,新疆维吾尔自治区乌鲁木齐市830002 [2]新疆医科大学第六附属医院护理单元,新疆维吾尔自治区乌鲁木齐市830002 [3]武警兵团总队医院外一科,新疆维吾尔自治区乌鲁木齐市830061

出　　处：《中国组织工程研究》2019年第15期2332-2337,共6页Chinese Journal of Tissue Engineering Research

基　　金：新疆生产建设兵团自然科学基金(2015AD004);项目负责人:张磊~~

摘　　要：背景:保留残端重建前交叉韧带能否提高膝关节本体感觉目前仍存在较大争议,如果能通过实验对保留残端重建前交叉韧带移植腱中本体感受器、神经生长、电生理情况进行直接检测,将能更加客观的评价保留残端对本体感觉恢复的作用。目的:建立残端鞘内重建、牵张保残重建和不保残重建前交叉韧带动物实验模型,比较3种重建手术术后膝关节本体感觉是否存在差异。方法:96只新西兰兔随机分为空白对照组、不保残组、牵张保残组和残端鞘内保残组,每组24只。除空白对照组外,其他3组兔进行双膝前交叉韧带重建。术后3,6,12周各组行膝关节电生理检测;实时荧光定量PCR检测移植腱神经营养因子3 mRNA的表达;苏木精-伊红染色、免疫组织化学染色观察重建组移植腱本体感受器数量。结果与结论:①术后3,6,12周,重建的3组兔移植物神经营养因子3mR NA表达、本体感受器数量、腘绳肌肌电图差异均无显著性意义(P> 0.05);②结果说明,保留残端重建前交叉韧带与不保留残端重建前交叉韧带膝关节本体感觉再生情况无明显差异。BACKGROUND:Whether remnant preservation can improve proprioception of knee joint remains a controversy.Direct detection of proprioceptor,nerve growth and electrophysiological changes in the grafting tendon of remnant preservation in anterior cruciate ligament reconstruction can objectively evaluate the effect of remnant preservation on proprioception recovery.OBJECTIVE:To establish the animal models of anterior cruciate ligament reconstruction with remnant preservation(femoral tensioning and augmented suture),with remnant preservation(graft passing remnant anterior cruciate ligament sheath)and without remnant,and to compare the differences in postoperative knee proprioception among methods.METHODS:Ninety-six New Zealand rabbits were randomly divided into control group,anterior cruciate ligament reconstruction groups with remnant preservation(femoral tensioning and augmented suture),with remnant preservation(graft passing remnant anterior cruciate ligament sheath)and without remnant(n=24/group).At 3,6 and 12 weeks after surgery,electrophysiological examination of knee joint was performed.The mRNA expression of neurotrophic factor 3 was detected by real-time fluorescent quantitative PCR.The number of proprioceptor in graft tendon in the anterior cruciate ligament reconstruction groups was detected by hematoxylin-eosin staining and immunohistochemistry.RESULTS AND CONCLUSION:(1)At postoperative 3,6 and 12 weeks,there were no significant differences in mRNA expression of neurotrophic factor 3,number of proprioceptor and electromyography hamstring among anterior cruciate ligament reconstruction groups(P >0.05).(2)To conclude,there is no significant difference in the proprioception recovery of knee joint between anterior cruciate ligament reconstruction with and without remnant preservation.

关 键 词：前交叉韧带重建 保残 神经营养因子3 本体感受器 腘绳肌肌电图 牵张保残重建 不保残重建前交叉韧带 移植腱本体感受器 前交叉韧带 本体感觉 肌电描记术 组织工程 

分 类 号：R446[医药卫生—诊断学]