促进前交叉韧带重建术后移植肌腱愈合的生物活性策略研究进展  

Research progress on bioactive strategies for promoting tendon graft healing after anterior cruciate ligament reconstruction

作　　者：蔡武峰 李箭[1] 李棋[1] CAI Wufeng;LI Jian;LI Qi(Department of Orthopedics,Orthopedic Research Institute,West China Hospital,Sichuan Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院骨科骨科研究所,成都610041

出　　处：《中国修复重建外科杂志》2023年第10期1292-1299,共8页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：四川省科技厅重点研发项目(2023YFG0221)。

摘　　要：目的 对促进前交叉韧带重建术(anterior cruciate ligament reconstruction,ACLR)术后移植肌腱愈合的生物活性策略进行综述,以期为提升ACLR疗效提供参考。方法 广泛查阅国内外促进ACLR术后移植肌腱愈合的生物活性策略相关文献,并进行归纳和总结。结果 目前,与ACLR术后移植肌腱愈合相关的生物活性材料主要有以下几类:生长因子、细胞、可降解植入物/组织衍生物。通过构建模拟原生前交叉韧带(anterior cruciate ligament,ACL)生长所需基质、环境及调控因素的复杂界面,在不同层面调控移植肌腱植入后的生长,从而促进移植肌腱愈合。尽管多数研究中ACLR疗效已得到了显著提升,但大部分仍局限于早期动物实验阶段,离真正临床推广仍有较远距离。此外,受限于当下制备技术,对界面的仿生仍多停留于微米、毫米级,并且偏向于形态学仿生,在信号机制通路上的研究依旧不足。结论 随着对ACL解剖学、发育学研究的深入及制备技术的改进,促进ACLR术后移植肌腱愈合的生物活性策略研究有望得到进一步提升。Objective To review the bioactive strategies that enhance tendon graft healing after anterior cruciate ligament reconstruction(ACLR),and to provide insights for improving the therapeutic outcomes of ACLR.Methods The domestic and foreign literature related to the bioactive strategies for promoting the healing of tendon grafts after ACLR was extensively reviewed and summarized.Results At present,there are several kinds of bioactive materials related to tendon graft healing after ACLR:growth factors,cells,biodegradable implants/tissue derivatives.By constructing a complex interface simulating the matrix,environment,and regulatory factors required for the growth of native anterior cruciate ligament(ACL),the growth of transplanted tendons is regulated at different levels,thus promoting the healing of tendon grafts.Although the effectiveness of ACLR has been significantly improved in most studies,most of them are still limited to the early stage of animal experiments,and there is still a long way to go from the real clinical promotion.In addition,limited by the current preparation technology,the bionics of the interface still stays at the micron and millimeter level,and tends to be morphological bionics,and the research on the signal mechanism pathway is still insufficient.Conclusion With the further study of ACL anatomy,development,and the improvement of preparation technology,the research of bioactive strategies to promote the healing of tendon grafts after ACLR is expected to be further promoted.

关 键 词：前交叉韧带损伤 生物活性策略 腱骨愈合 移植物韧带化 

分 类 号：R687.2[医药卫生—骨科学]