活动对兔前交叉韧带重建腱-骨愈合的影响
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苏州大学附属第二医院

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国家自然科学基金项目(青年项目)


Effect of motion on tendon-bone healing in a rabbit anterior cruciate ligament reconstruction model
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The Second Affiliated Hospital of Soochow University

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    摘要:

    目的 观察不同应力环境下兔前交叉韧带(anterior cruciate ligament,ACL)重建术后腱骨愈合的效果。方法 64只6月龄新西兰白兔右膝关节使用自体半腱肌腱行ACL重建术。术后2周开始,根据膝关节活动方式的不同随机分为四组:固定(immobilization, IM)组、自由活动(free motion, FM)组、低强度活动(low-intensity motion, LIM组以及高强度活动(high-intensity motion, HIM)组。术后8周所有动物膝关节标本行组织学观察、评分以及生物力学测试。结果 与FM组相比,IM组腱骨界面仍存在较明显的界限、裂隙,更多的炎症细胞和血管组织,且未见任何软骨细胞,组织学评分(P>0.05)和抗拔出强度(P<0.05)均低于FM组;而LIM组腱骨界面结构最接近于正常腱骨止点,相比于其余各组,其组织学评分以及肌腱抗拔出强度均较高(P<0.05),HIM组中3例出现早期内固定失效,腱骨界面组织学评分以及肌腱抗拔出强度均低于LIM组(P<0.05),但均高于FM组(P<0.05)。结论 ACL重建术后适当的应力刺激可提高腱骨愈合质量。固定以及高强度活动均不利于腱骨愈合,可能导致腱骨愈合进程的缓慢或者早期失败。

    Abstract:

    Objective To observe the effect of different mechanical stress conditions on tendon-bone healing in a rabbit anterior cruciate ligament(ACL) reconstruction model. Methods Sixty-four 6-month-old New Zealand white rabbits underwent ACL reconstruction using autologous semitendinosus tendon on the right knee joint. 2 weeks after operation, according to the motion intensity, all animals were randomly divided into four groups: immobilization (IM) group, free motion (FM) group, low-intensity motion (LIM) group and high-intensity motion (HIM), HIM group, Eight weeks after surgery, all the knee joints were evaluated by histological analysis and biomechanical testing. Results Compared with FM group, the tendon-bone interface in the IM group still had obvious boundaries and fissures, more inflammatory cells and vascular tissue, and no chondrocyte was found. Histological scores (P>0.05) and ultimate load to failure (P<0.05) were lower. The tendon-bone interface of the LIM group was closest to the normal tendon-bone insertion point. Compared with other groups, LIM group had a higher histological score and ultimate load to failure(P<0.05). Early internal fixation failure occurred in 3 cases in the HIM group, the histological score and ultimate load to failure were lower than those of the LIM group(P<0.05), and higher than that of the FM group(P<0.05). Conclusion Appropriate stress stimulation after ACL reconstruction can improve the quality of tendon-bone healing. Neither of immobilization nor a high-intensity motion benefits to tendon-bone healing, which may delay tendon-bone healing process or lead to early failure of ACL reconstruction.

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  • 收稿日期:2022-01-17
  • 最后修改日期:2022-03-30
  • 录用日期:2022-06-07
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