Karaoglu Sinan, B Fisher Matthew, Woo Savio L-Y, Fu Yin-Chih, Liang Rui, Abramowitch Steven D
Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, 405 Center for Bioengineering, 300 Technology Drive, Pittsburgh, Pennsylvania 15219, USA.
J Orthop Res. 2008 Feb;26(2):255-63. doi: 10.1002/jor.20471.
Following harvest of a bone-patellar tendon-bone (BPTB) autograft, the central third of the patellar tendon (PT) does not heal well. The healing tissues also form adhesions to the fat pad and can cause abnormal patellofemoral joint motion. The hypotheses were that a bioscaffold could enhance patellar tendon healing through contact guidance and chemotaxis, and the scaffold could serve as a barrier to decrease adhesion formation between the neo-PT and infrapatellar fat pad. In 20 New Zealand White rabbits, a central-third PT defect was created. One strip of porcine small intestinal submucosa (SIS) was attached to both the anterior and posterior sides of the PT defect of the SIS-treated group (n = 10). For comparison, a central defect was left nontreated (n = 10). At 12 weeks, histomorphology was examined using Masson's trichrome staining. The cross-sectional area (CSA) was determined with a laser micrometer, and the central BPTB complexes were tested in uniaxial tension. SIS-treated samples showed a greater amount of healing tissue with denser and well-oriented collagen fibers and more spindle-shaped cells. There was no noticeable adhesion formation in the SIS-treated group. For the nontreated group, there were significantly more and diffuse adhesive formations. The SIS-treated group also had a 68% increase in neo-PT CSA, 98% higher stiffness, and 113% higher ultimate load than that in the nontreated group. SIS treatment increased the quantity of healing tissue, improved the histological appearance and biomechanical properties of the neo-PT, and prevented adhesion formation between the PT and fat pad.
在收获骨-髌腱-骨（BPTB）自体移植物后，髌腱（PT）的中间三分之一愈合不佳。愈合组织还会与脂肪垫形成粘连，并可能导致髌股关节运动异常。研究假设为生物支架可通过接触引导和趋化作用促进髌腱愈合，且该支架可作为屏障减少新生髌腱与髌下脂肪垫之间粘连的形成。在20只新西兰白兔中，制造了中间三分之一髌腱缺损。将一条猪小肠黏膜下层（SIS）附着于SIS治疗组（n = 10）髌腱缺损的前后两侧。作为对照，对10只兔子的中央缺损未进行处理。12周时，使用Masson三色染色法检查组织形态学。用激光测微仪测定横截面积（CSA），并对中央BPTB复合体进行单轴拉伸测试。SIS治疗组的样本显示愈合组织量更多，胶原纤维更致密且排列方向良好，梭形细胞更多。SIS治疗组未观察到明显的粘连形成。对于未处理组，粘连形成明显更多且更弥散。SIS治疗组的新生髌腱CSA也比未处理组增加了68%，刚度高98%，极限载荷高113%。SIS治疗增加了愈合组织的量，改善了新生髌腱的组织学外观和生物力学性能，并防止了髌腱与脂肪垫之间粘连的形成。
