Gomez M A, Woo S L, Amiel D, Harwood F, Kitabayashi L, Matyas J R
University of Colorado Health Sciences Center, Department of Orthopaedics, Denver 80262.
Am J Sports Med. 1991 Jul-Aug;19(4):347-54. doi: 10.1177/036354659101900405.
The effects of motion and increased levels of stress on the biomechanical, biochemical, and morphological properties of healing medial collateral ligaments were assessed in a rabbit model. In one group, the medial collateral ligament of the left hindlimb was transected and allowed to heal with cage activity for either 6 or 12 weeks. In another group, the transected ligaments were permitted to heal for 4 weeks and then were placed under increased stress by inserting a stainless steel pin perpendicularly underneath the healing medial collateral ligament. The animals were allowed cage activity for an additional 2 or 8 weeks. The varus-valgus joint laxity and the stress-strain properties of the medical collateral ligament substance were obtained. Further, the quantity of total collagen, amount and ratio of the collagen cross-links, dihydroxylysinonorleucine and hydroxylysinonorleucine, and the histologic appearance of the healing medical collateral ligaments were evaluated for all groups. At 6 weeks, knees with a transected medial collateral ligament were twice as lax as the controls. However, joints with the stainless steel tension pin had varus-valgus values approximately 1.5 times those of the controls. At 12 weeks, joints with increased stress were not statistically different from the controls. The group that had healing with increased stress for 12 weeks produced the highest stress for a given strain compared to any other group. Also, the total collagen levels and the ratio of dihydroxylysinonorleucine/hydroxylysinonorleucine were the closest to normal of any transected group. Finally, qualitative histologic improvements were seen, including a more longitudinal arrangement of collagen fibers and decreased cellularity.
在兔模型中评估了运动和应激水平增加对内侧副韧带愈合过程中的生物力学、生物化学和形态学特性的影响。在一组中，切断左后肢的内侧副韧带，让其在笼内活动6周或12周进行愈合。在另一组中，切断的韧带先愈合4周，然后在愈合的内侧副韧带下方垂直插入一根不锈钢针，使其承受增加的应力。动物再进行2周或8周的笼内活动。测量了内翻-外翻关节松弛度以及内侧副韧带组织的应力-应变特性。此外，还评估了所有组中总胶原蛋白的含量、胶原蛋白交联物的数量和比例、二羟基赖氨酸正亮氨酸和羟基赖氨酸正亮氨酸，以及愈合的内侧副韧带的组织学外观。6周时，内侧副韧带切断的膝关节松弛度是对照组的两倍。然而，带有不锈钢张力针的关节内翻-外翻值约为对照组的1.5倍。12周时，承受增加应力的关节与对照组在统计学上无差异。与其他任何组相比，承受增加应力愈合12周的组在给定应变下产生的应力最高。此外，在所有切断组中，该组的总胶原蛋白水平以及二羟基赖氨酸正亮氨酸/羟基赖氨酸正亮氨酸的比例最接近正常水平。最后，观察到了组织学上的定性改善，包括胶原纤维排列更呈纵向且细胞数量减少。
