Lopez Mandi J, Markel Mark D, Kalscheur Vicki, Lu Yan, Manley Paul A
Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA.
Vet Surg. 2003 Jul-Aug;32(4):390-401. doi: 10.1053/jvet.2003.50042.
To investigate the harvest and application of hamstring grafts for canine cranial cruciate ligament (CrCL) reconstruction.
Experimental study.
Four adult female hounds, weighing 26.3 +/- 1.6 kg (mean +/- SEM). METHODS-One stifle in each dog was randomly chosen for hamstring graft CrCL reconstruction after native CrCL transection. Arthroscopy was performed to evaluate graft integrity at 12 weeks. Gait analysis and stifle radiographs were performed preoperatively and up to 52 weeks after graft placement. Dogs were killed 12 (n = 2) or 52 weeks (n = 2) after CrCL reconstruction. Tissues were evaluated grossly and with light and confocal laser microscopy.
Hamstring grafts were intact in all stifles at 12 weeks (n = 4) and 52 weeks (n = 2). Grossly, there was no osteoarthritis in stifles at 12 weeks and only chondrophytes along the trochlear ridges at 52 weeks. Minimal radiographic evidence of osteoarthritis developed in stifles with grafts during the study. Lameness in limbs with grafts resolved by 52 weeks. Graft tissue was highly vascular, ligamentized, and undergoing active remodeling at 12 weeks. Fifty-two weeks after graft placement, intraarticular graft tissue was well vascularized, mature, and encapsulated by synovium, and graft-bone interfaces were characterized by Sharpey's fiber insertions. There was no evidence of graft necrosis using confocal laser microscopy at either time point.
The hamstring graft technique may be a viable method of canine CrCL reconstruction.
Hamstring grafts may be an alternative technique for canine CrCL reconstruction. Further study is needed before clinical application.
研究犬颅交叉韧带(CrCL)重建中腘绳肌腱移植的获取与应用。
实验研究。
4只成年雌性猎犬,体重26.3±1.6千克(平均值±标准误)。
在每只犬的一侧后肢切断天然CrCL后,随机选择一侧后肢进行腘绳肌腱移植CrCL重建。术后12周进行关节镜检查以评估移植肌腱的完整性。术前及移植后直至52周进行步态分析和后肢X线片检查。在CrCL重建后12周(n = 2)或52周(n = 2)处死犬。对组织进行大体观察、光镜和共聚焦激光显微镜检查。
术后12周(n = 4)和52周(n = 2)时,所有后肢的腘绳肌腱移植均完整。大体观察,术后12周时后肢无骨关节炎,52周时仅滑车嵴处有骨赘。在研究期间,移植肌腱的后肢出现了极轻微的骨关节炎影像学证据。移植肌腱的肢体跛行在52周时消失。术后12周,移植肌腱组织血管丰富、已韧带化且正在进行活跃重塑。移植后52周,关节内移植肌腱组织血管化良好、成熟且被滑膜包裹,移植肌腱与骨的界面有Sharpey纤维插入。在两个时间点,共聚焦激光显微镜检查均未发现移植肌腱坏死的证据。
腘绳肌腱移植技术可能是犬CrCL重建的一种可行方法。
腘绳肌腱移植可能是犬CrCL重建的一种替代技术。在临床应用前还需要进一步研究。