Holzmüller W, Rehm K E, Perren S M
Unfall-, Hand- und Wiederherstellungschirurgie, Universität zu Köln.
Unfallchirurg. 1992 Jun;95(6):306-10.
In 25 sheep the anterior cruciate ligament (ACL) was reconstructed after resection. Twelve modified "Jones procedures" were performed (transplantation of the central third of the patellar tendon with an initial load of 50 N) and 13 polydioxanone (PDS) augmentations. In 15 cases the ACL was resected from the right knee. Twenty-one sheep survived for 1 year and were then evaluated. Loss of the ACL leads to instable joints in this experiment. Within the first 6 months anterior translation occurs; after 1 year subluxations can be seen on the X-ray films. Macroscopical signs of extensive arthrosis were seen in the femorotibial and femoropatellar joints; the menisci were totally destroyed. Macroscopically strong ligaments were seen 1 year after PDS-augmented reconstruction as well as after transplantation of the patellar tendon with an initial load of 50 N. There was no difference between the two groups. The mechanical strength reached 54% of the maximum load of a control group in the Jones reconstructions and 61% after additional augmentation with a 2-mm biodegradable PDS cord. There was no statistically significant difference. Both methods are suitable for reconstruction of the ACL; the patellar tendon replaces the ACL very well.
在25只绵羊中,前交叉韧带(ACL)切除后进行重建。实施了12例改良“琼斯手术”(移植髌腱中三分之一,初始负荷为50 N)和13例聚二氧六环酮(PDS)增强术。15例中ACL从右膝切除。21只绵羊存活1年,然后进行评估。在本实验中,ACL缺失导致关节不稳定。在最初6个月内出现前向移位;1年后在X线片上可见半脱位。在股骨胫骨和股骨髌骨关节可见广泛关节病的宏观体征;半月板完全破坏。在PDS增强重建后1年以及初始负荷为50 N的髌腱移植后,肉眼可见韧带牢固。两组之间无差异。在琼斯重建中,机械强度达到对照组最大负荷的54%,在额外用2毫米可生物降解PDS绳增强后达到61%。无统计学显著差异。两种方法都适用于ACL重建;髌腱能很好地替代ACL。