不同运动强度跑台训练对前交叉韧带重建术后大鼠腱骨愈合的影响  

The effects of treadmill training with different intensities on tendon-bone healing in rats after anterior cruciate ligament reconstruction

作　　者：梁婷 朱亮 赵旭良 赵海波 江帆 于腾波 Liang Ting;Zhu Liang;Zhao Xuliang;Zhao Haibo;Jiang Fan;Yu Tengbo(Department of Rehabilitation Medicine,Qingdao Municipal Hospital(University of Health and Rehabilitation Sciences),Qingdao 266071,China;Department of Medicine,Qingdao University,Qingdao 266000,China;Department of Orthopedic Surgery,Qingdao Municipal Hospital(University of Health and Rehabilitation Sciences),Qingdao 266071,China;Bone and Joint Surgery and Trauma Surgery Center,Qingdao Traditional Chinese Medicine Hospital(Qingdao Hiser Hospital),Qingdao Hiser Hospital Affiliated to Qingdao University,Qingdao 266071,China)

机构地区：[1]青岛市市立医院(康复大学青岛医院)康复医学科,青岛266071 [2]青岛大学医学部,青岛266000 [3]青岛市市立医院(康复大学青岛医院)骨关节外科,青岛266071 [4]青岛市中医医院(青岛市海慈医院),青岛大学附属青岛市海慈医院骨关节外科与创伤外科中心,青岛266071

出　　处：《中华创伤骨科杂志》2024年第10期890-898,共9页Chinese Journal of Orthopaedic Trauma

基　　金：山东省重点研发计划项目(2021SFGC0502);青岛市市南区科技局计划项目(2023-2-011-YY)

摘　　要：目的探讨不同运动强度的跑台训练对前交叉韧带(ACL)重建术后腱骨愈合的影响。方法共选取99只成年雄性Sprague-Dawley大鼠进行研究, 随机选择90只大鼠应用自体尾肌肌腱行ACL重建术, 术后2周随机分为低强度跑台训练组(L组, 以12 m/min的速度进行跑台训练, n=30)和中等强度跑台训练组(M组,以18 m/min的速度进行跑台训练, n=30)、自由活动组(C组,在笼中自由活动, n=30)。其余大鼠作为空白对照组(N组, n=9), 不作任何处理。术后2周末开始跑台训练。采用Micro-CT分析、苏木精-伊红(HE)染色、力学测试、实时荧光定量多聚酶链式反应(qPCR)、蛋白印迹分析(Western-blot)评估腱骨愈合质量。结果术后2周3组Micro-CT上股骨侧、胫骨侧骨隧道面积和骨体积分数(BV/TV)比较差异均无统计学意义(P>0.05)。术后4、8周, C、M、L组股骨侧、胫骨侧骨隧道面积均依次递减, 股骨侧、胫骨侧骨隧道BV/TV均依次递增, 两两比较差异均有统计学意义(P<0.05)。术后8周, HE染色显示L组腱骨愈合成熟度评分显著高于C、M组, 差异均有统计学意义(P<0.05)。C、M、L、N组的刚度和最大失效载荷依次呈现递增趋势。M组的刚度以及N、L组刚度和最大失效载荷均显著大于C组, 差异均有统计学意义(P<0.05)。C、M、L组间的骨桥蛋白(OPN)、Ⅱ型胶原α1链基因(COL2α1)的mRNA相对表达量以及骨钙素、OPN、COL2α1蛋白表达量依次呈现递增趋势, 两两比较差异均有统计学意义(P<0.05)。结论术后2周末开始的跑台训练有利于腱骨界面的愈合, 提高腱骨复合体的生物力学强度。低强度的机械刺激更有利于腱骨复合体的新骨生成和胶原纤维重塑。Objective To investigate the effects of treadmill training with different intensities on tendon-bone healing in rats after anterior cruciate ligament(ACL)reconstruction.Methods Of the 99 adult male Sprague-Dawley(SD)rats used for this study,90 were randomly selected to undergo ACL reconstruction with autologous caudal tendon.Two weeks after the surgical reconstruction,the 90 SD rats were randomized into a low-intensity group(group L,n=30)subjected to treadmill training at a speed of 12 m/min,a moderate-intensity group(group M,n=30)subjected to treadmill training at a speed of 18 m/min,and a free group(group C,n=30)subjected to free activities in the cage as a model control.The other 9 rats were set as a blank control(group N,n=9)subjected to no treatment at all.The treadmill training started at the end of 2 weeks after surgical reconstruction.Hematoxylin-eosin(HE),micro-CT analysis,mechanical testing,real-time quantitative polymerase chain reaction(qPCR)and western blot analysis were used to evaluate the quality of tendon-bone healing.Results There were no significant differences in the areas of femoral and tibial lateral bone tunnels or the total bone volume ratio(BV/TV)between the 3 groups 2 weeks after surgery(P>0.05).At 4 weeks and 8 weeks after surgery,the areas of lateral tibial bone tunnel and lateral femoral tunnel in groups C,M and L showed a decreasing trend(P<0.05)while the BV/TV of lateral femoral tunnel and the BV/TV of lateral tibial tunnel in groups C,M and L showed an increasing trend(P<0.05).At 8 weeks after surgery,HE staining showed that the tendon-bone healing was the most mature in group L,followed by group M,and the least mature in group C,showing statistically significant differences(P<0.05).The stiffness and maximum failure load showed an increasing trend from group C to group M to group L to group N.The stiffness in group M and the stiffness and maximum failure load in groups N and L were significantly higher than those in group C(P<0.05).The relative mRNA expression levels of osteopontin

关 键 词：前交叉韧带 运动疗法 膝关节 大鼠 腱骨愈合 

分 类 号：R687.3[医药卫生—骨科学]