Sonoda M, Harwood F L, Amiel M E, Moriya H, Temple M, Chang D G, Lottman L M, Sah R L, Amiel D
Orthopaedics and Sports Medicine, Kawatetsu Hospital, Chiba, Japan.
Am J Sports Med. 2000 Jan-Feb;28(1):90-7. doi: 10.1177/03635465000280012801.
To assess the effect of hyaluronan on meniscus injury and repair, we had 35 mature New Zealand White rabbits undergo bilateral meniscus injury and repair (19 in the peripheral region, and 16 in the inner region). A longitudinal tear was created in the medial meniscus and repaired with horizontally placed nylon sutures. The left knee joint received intraarticular injections of hyaluronan 1 week after surgery and once a week for 5 weeks. The right knees were injected with phosphate-buffered saline (the carrier vehicle of the hyaluronan). Twelve weeks after repair, tears in the peripheral region showed gross and histologic evidence of healing, with no difference between the vehicle- and hyaluronan-treated menisci. Biochemically, the ratio of reducible collagen cross-links in the hyaluronan-treated menisci was significantly higher than in the vehicle-treated menisci, indicating greater level of collagen remodeling. Biomechanically the vehicle- and hyaluronan-treated menisci demonstrated similarly high tearing load and fracture toughness. In the inner region, poor healing response was observed grossly and histologically in both treatment groups. Water content in the hyaluronan-treated menisci was significantly lower than in the vehicle-treated menisci, indicating a lower level of swelling. Hyaluronan treatment stimulated collagen remodeling in the peripheral region and inhibited swelling of the meniscus repaired in the inner region.
为评估透明质酸对半月板损伤及修复的影响，我们让35只成年新西兰白兔接受双侧半月板损伤及修复手术（19只在外周区域，16只在内侧区域）。在内侧半月板制造一个纵向撕裂口，并用水平放置的尼龙缝线进行修复。术后1周，对左膝关节进行关节内注射透明质酸，每周注射1次，共注射5周。右膝注射磷酸盐缓冲盐水（透明质酸的载体）。修复12周后，外周区域的撕裂口在大体和组织学上均显示愈合迹象，接受载体和透明质酸治疗的半月板之间无差异。生化方面，接受透明质酸治疗的半月板中可还原胶原蛋白交联的比例显著高于接受载体治疗的半月板，表明胶原蛋白重塑水平更高。生物力学上，接受载体和透明质酸治疗的半月板表现出相似的高撕裂负荷和断裂韧性。在内侧区域，两个治疗组在大体和组织学上均观察到较差的愈合反应。接受透明质酸治疗的半月板中的含水量显著低于接受载体治疗的半月板，表明肿胀程度较低。透明质酸治疗可刺激外周区域的胶原蛋白重塑，并抑制内侧区域修复的半月板的肿胀。
