Atkinson P J, Oyen-Tiesma M, Zukosky D K, DeCamp C E, Mackenzie C D, Haut R C
Department of Materials Science and Mechanics, College of Engineering, Michigan State University, East Lansing 48824, USA.
J Orthop Res. 1999 Jan;17(1):28-36. doi: 10.1002/jor.1100170106.
The central third of the patellar tendon is commonly used to reconstruct the injured anterior cruciate ligament. Some studies have noted changes in joint tissues following this procedure. It has been postulated that these changes may be associated with increased stress on the remaining tendon following harvest of the graft. In our study, the central third of the patellar tendon was excised in three groups of rabbits. The central tendon defects in two of the three groups were fitted with different augmentation devices to augment the host tendon during the healing process. All rabbits followed a daily treadmill exercise regimen for 12 weeks following the operation. Biomechanical testing of the tendon revealed that in nonaugmented tendons the cross-sectional area and the length of the patellar tendon significantly increased 112 and 16%, respectively. There was histological evidence of host-tendon remodeling throughout the cross section and extensive fibrosis in the infrapatellar fat pad. Augmentation of the tendon significantly reduced these changes, with the least change noted in the group with the greatest augmentation. The rabbits with augmentation devices retained tendon dimensions similar to those of the contralateral intact tendon, and tendon remodeling occurred only in the defect area. The rabbits with augmentation devices exhibited little to no fibrosis of the fat pad. Structural properties of augmented and nonaugmented tendons were similar despite the size differences, indicating higher tissue quality in the augmented tendons. This study suggested that complications of the knee joint (i.e., tendon proliferation and fat pad fibrosis) noted after anterior cruciate-ligament reconstruction with the autogenous patellar tendon may be limited by the implantation of an augmentation device.
髌腱的中央三分之一常用于重建受损的前交叉韧带。一些研究指出了该手术后关节组织的变化。据推测，这些变化可能与移植物取材后剩余肌腱上的应力增加有关。在我们的研究中，在三组兔子身上切除了髌腱的中央三分之一。三组中的两组中央腱缺损处安装了不同的增强装置，以便在愈合过程中增强宿主肌腱。所有兔子在手术后均遵循每日跑步机运动方案，持续12周。对肌腱进行生物力学测试发现，在未增强的肌腱中，髌腱的横截面积和长度分别显著增加了112%和16%。有组织学证据表明整个横截面上存在宿主肌腱重塑，并且髌下脂肪垫中有广泛的纤维化。肌腱增强显著减少了这些变化，在增强程度最大的组中变化最小。安装了增强装置的兔子的肌腱尺寸与对侧完整肌腱相似，并且肌腱重塑仅发生在缺损区域。安装了增强装置的兔子的脂肪垫几乎没有或没有纤维化。尽管尺寸不同，但增强和未增强肌腱的结构特性相似，表明增强肌腱的组织质量更高。这项研究表明，自体髌腱重建前交叉韧带后出现的膝关节并发症（即肌腱增生和脂肪垫纤维化）可能通过植入增强装置来限制。
