Philippon Marc J, Arnoczky Steven P, Torrie Alec
Steadman Hawkins Clinic, Vail, Colorado, USA.
Arthroscopy. 2007 Apr;23(4):376-80. doi: 10.1016/j.arthro.2007.01.017.
Recently, arthroscopic repair has been advocated for the treatment of labral tears. The purpose of this study was to document the histologic healing process in an arthroscopically repaired acetabular-labral detachment in an ovine model.
A total of 10 skeletally mature female sheep underwent unilateral arthroscopic labral repair. A 1.5-cm-long incision was made at the junction of the labrum and acetabulum. The labral detachment was then repaired arthroscopically with a single suture anchor. Postoperatively, the animals were confined to small indoor pens, and no form of immobilization was used. After 12 weeks, the animals were killed and the labral repair evaluated via routine histology. Normal labra from 3 nonoperative animals were also processed for histology.
The acetabular labrum of the sheep is an avascular, fibrocartilaginous structure similar in anatomic design to that of human beings. All arthroscopically repaired labra appeared stable and grossly healed at 12 weeks. Histologically, labral healing appeared to occur via fibrovascular scar tissue originating from the joint capsule or the exposed bony attachment of the labrum (or both). However, the labral healing was incomplete in all specimens, with a shallow, superficial cleft remaining at the junction of the labrum and the articular surface of the acetabulum.
Arthroscopically repaired acetabular-labral lesions in sheep are capable of healing via fibrovascular repair tissue or direct reattachment via new bone formation (or both).
The ability of labral detachments to heal in this animal model provides the rationale for additional investigations into the clinical efficacy of arthroscopic labral repair in human beings.
近来，关节镜下修复术被提倡用于治疗盂唇撕裂。本研究的目的是记录在羊模型中关节镜下修复髋臼盂唇分离后的组织学愈合过程。
总共10只骨骼成熟的雌性绵羊接受了单侧关节镜下盂唇修复术。在盂唇与髋臼的交界处做一个1.5厘米长的切口。然后通过单个缝线锚钉在关节镜下修复盂唇分离。术后，动物被限制在室内小围栏中，未采用任何形式的固定。12周后，处死动物并通过常规组织学评估盂唇修复情况。还对3只未手术动物的正常盂唇进行了组织学处理。
绵羊的髋臼盂唇是一种无血管的纤维软骨结构，其解剖设计与人类相似。所有关节镜下修复的盂唇在12周时均显得稳定且大体愈合。组织学上，盂唇愈合似乎是通过源自关节囊或盂唇暴露的骨附着处（或两者）的纤维血管瘢痕组织实现的。然而，所有标本中的盂唇愈合均不完全，在盂唇与髋臼关节面的交界处仍残留一个浅而表浅的裂隙。
绵羊关节镜下修复的髋臼盂唇损伤能够通过纤维血管修复组织或通过新骨形成直接重新附着（或两者）实现愈合。
盂唇分离在该动物模型中的愈合能力为进一步研究关节镜下盂唇修复术在人类中的临床疗效提供了理论依据。
