摘要
目的观察兔四股半腱肌腱移植物重建前十字韧带后骨道内末端形成和转归的情况。方法成年健康新西兰白兔20只，体重2．9~3．5kg，平均3．2kg。行下肢双侧半腱肌腱反折四股重建右膝前十字韧带，按术后3、6、12、26、52周随机分组，按时间段处死实验动物，每组有2只取材成功后，剩余实验动物即进入下一时间段。实验动物处死后，取右膝关节，打开关节腔，取骨道部分标本常规固定、脱水、透明、包蜡、切片、HE染色，组织学观察骨道内移植物及腱骨交界处生长情况。结果3周时腱骨交界处形成一富含血管的纤维结缔组织；骨遭内肌腱部分发生坏死，周边细胞已长入。6周时各处连接情况不十分平行，骨道内腱组织亦被替代。12周时界面组织不同部位也出现生长明显不平行情况。26周时界面组织的成熟程度比较平行，可以见到比较典型的直接止点结构。52周时界面组织基本以直接止点连接为主，但在骨道内仍有部分不成熟的腱，仍可见到不同束之间的界限。结论四股半腱肌腱作为前十字韧带的移植物，同样在骨道内通过界面组织的不断成熟，逐渐形成连接，并向直接止点过渡，但因不同股的存在而不平行。由于应力屏蔽的作用，骨道内部的移植物无法完全塑形，仍保留分束的状态。
Objective In order to observe the histological change of the remodel progress of the intra-tunnel part of the four-band hamstring tendon which used for anterior cruciate ligament reconstruction on the rabbit. Methods Twenty healthy adult New Zealand rabbits with the average weight of 3.2 kg were involved in this study. The anterior cruciate ligament of each rabbit＇s right knee was reconstructed with it＇s bilateral four-band semitendinosus tendons. All rabbits were divided 5 groups randomly and killed. Open the right knee joints and collect the specimens at 3, 6, 12, 26, 52 weeks after the operation respectively. Make sure each group included two complete specimens. All specimens got fixation, dehydration, clearing, embedding, sectioning, and Hematoxylin and Eosin staining. The histological change of the intra-tunnel of the four-band tendon were observed and compared. The data obtained were statistically analyzed. Results At 3 weeks, a connective tissue interface was formed, necrosis of the intra-tunnel graft was observed and the peripheral cell had ingrowthed. At 6 weeks the growth level of the interface was not equal. At 12 weeks, the un-synchronization of the interface was still evident. At 26 weeks the four-layer direct insertion started to show, and the growth of the interface was synchronized. At 52 weeks, the interface was mainly composed of the direct insertion. But the un-matured graft and the inter-bundle gaps still could be seen within the tunnel. Conclusion The intra-tunnel part of the four band semitendinous tendons graft for anterior cruciate ligament reconstruction still need a remodeling progress. The healing of the tendon-bone may pass through an indirect to direct connection progress but un-synchronized of each different band. The four-band graft within the tunnel seemed could not accomplish the remodeling progress due to the shield effect of the stress and remained separated.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2007年第2期129-133,共5页
Chinese Journal of Orthopaedics
关键词
前交叉韧带
兔
移植物
腱转移术
Anterior cruciate ligament
Rabbits
Transplants
Tendon transfer
