[骨保护素对兔前交叉韧带重建术后腱骨愈合的影响：组织形态学和影像学研究]

[The effect of osteoprotegerin on tendon-bone healing after reconstruction of the anterior cruciate ligament: a histomorphological and radiographical study in the rabbit].

作者信息

Dynybil C, Kawamura S, Kim H J, Ying L, Perka C, Rodeo S A

机构信息

Klinik für Orthopädie, Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin.

出版信息

Z Orthop Ihre Grenzgeb. 2006 Mar-Apr;144(2):179-86. doi: 10.1055/s-2006-921466.

DOI:10.1055/s-2006-921466

PMID:16625448

Abstract

AIM

Improvement of the bony incorporation of a soft-tissue graft after ACL reconstruction by local administration of Osteoprotegerin between the bone and tendon graft.

METHOD

Fifteen New Zealand White rabbits underwent unilateral anterior cruciate ligament (ACL) reconstruction using an autologous semitendinosis tendon graft. We compared the effect of three OPG doses (5 microg, 50 microg, or 100 microg) at the tendon-bone interface to the controls (OPG carrier) and ACL reconstruction only. Specimens were analyzed at 3 weeks using radiology, histology and histomorphometry to investigate the effect of OPG on the bony incorporation of the tendon graft.

RESULTS

Animals treated with OPG 100 microg had a significant (p = 0.007) increase in newly-formed bone around the graft compared to the control group (0.16 +/- 0.01 mm(2); 0.06 +/- 0.02 mm(2)). No significant differences were found between the controls and the other groups (tendon graft only, OPG 5 microg, and 50 microg) (p > 0.05). Bone mineral density, measured in image-pixel brightness (IPB; reference range: 0-255), along the edge of the bone tunnel was greater in the OPG 100 microg group (169.5 +/- 5.9 IPB) compared to the control group (150.3 +/- 4.3 IPB) but this was not statistically significant (p = 0.083). There was a significant decrease in the number of osteoclasts per high-power microscopic fields (HPF) lining the bone tunnel in the OPG 100 microg group compared to the control group (4.4 +/- 2.5 cells/HPF; 6.4 +/- 1.8 cells/HPF) (p = 0.022). No significant differences were found between the control group and the other groups in osteoclast numbers (p > 0.05).

CONCLUSION

Since tendon-bone healing requires new bone formation and bone ingrowth around a tendon graft, OPG may improve biologic graft fixation. A potential implication could be earlier return to function or better conditions in revision surgery.

摘要

目的

通过在骨与肌腱移植物之间局部给予骨保护素（Osteoprotegerin，OPG）来改善前交叉韧带（ACL）重建后软组织移植物的骨整合。

方法

15只新西兰白兔接受了使用自体半腱肌腱移植物的单侧前交叉韧带（ACL）重建。我们比较了在肌腱 - 骨界面处三种OPG剂量（5微克、50微克或100微克）与对照组（OPG载体）以及仅进行ACL重建的效果。在3周时使用放射学、组织学和组织形态计量学对标本进行分析，以研究OPG对肌腱移植物骨整合的影响。

结果

与对照组相比，接受100微克OPG治疗的动物移植物周围新形成的骨量显著增加（p = 0.007）（0.16 ± 0.01平方毫米；0.06 ± 0.02平方毫米）。对照组与其他组（仅肌腱移植物、5微克OPG和50微克OPG）之间未发现显著差异（p > 0.05）。与对照组（150.3 ± 4.3图像像素亮度（IPB）；参考范围：0 - 255）相比，100微克OPG组沿骨隧道边缘测量的骨矿物质密度更高（169.5 ± 5.9 IPB），但这在统计学上不显著（p = 0.083）。与对照组相比，100微克OPG组沿骨隧道内衬的每高倍显微镜视野（HPF）破骨细胞数量显著减少（4.4 ± 2.5个细胞/HPF；6.4 ± 1.8个细胞/HPF）（p = 0.022）。对照组与其他组在破骨细胞数量上未发现显著差异（p > 0.05）。