Huang Hong-shi, Ao Ying-fang, Wang Yong-jian, Li Xue
Institute of Sports Medicine, Third Hospital, Peking University, Beijing, China.
Zhonghua Wai Ke Za Zhi. 2008 Jul 15;46(14):1088-91.
To study the effects of continuous passive motion on the tendon-bone healing of the semi-tendinous tendon autograft used for anterior cruciate ligament (ACL) reconstruction in rabbits.
In 12 healthy 8-month-old male rabbits, an ACL reconstruction was performed by using double semi-tendinous tendon autograft. Postoperatively these animals were treated by either continuous passive motion (CPM) or cage activity. Specimens of the grafts were collected at 6, 12, 24 weeks postoperatively. Histological change in the tendon-bone healing was studied by haematoxylin-eosin and toluidine blue.
There was more new fiber tissue in the anterior half of the interface. Osteoclasts were most numerous at the tunnel aperture and in the anterior half of the interface. Cartilage in the tendon-bone interface was localized to the posterior aspect of tunnels, the area where compressive stress would be predicted. CPM group developed a denser connective tissue with less vascularity and cellularity. The bone tunnel had more areas with ingrowing denser connective tissue compared with cage activity specimens. With the growth of Sharpery's fibers and fibrocartilage into the interface, a direct ligament insertion was found. In the CPM specimens, the interface tissue was more mature and the direct insertion was broader and more structured.
Compressive stress promotes chondroid formation, and the tension promotes fiber formation. Tendon-bone healing may be optimized by CPM after tendon transplantation into a bone tunnel.
研究持续被动运动对兔前交叉韧带(ACL)重建中使用的半腱肌自体肌腱腱骨愈合的影响。
选取12只8月龄健康雄性兔,采用双半腱肌自体肌腱进行ACL重建。术后将这些动物分为持续被动运动(CPM)组或笼养活动组。术后6周、12周、24周采集移植物标本。采用苏木精-伊红染色和甲苯胺蓝染色研究腱骨愈合的组织学变化。
界面前半部分有更多的新生纤维组织。破骨细胞在隧道开口处和界面前半部分最多。腱骨界面的软骨位于隧道后侧,即预计有压应力的区域。CPM组形成了更致密的结缔组织,血管和细胞较少。与笼养活动组标本相比,骨隧道中有更多区域有向内生长的致密结缔组织。随着Sharpery纤维和纤维软骨长入界面,发现了直接的韧带附着。在CPM标本中,界面组织更成熟,直接附着更宽且更有结构。
压应力促进类软骨形成,张应力促进纤维形成。肌腱移植到骨隧道后,CPM可能会优化腱骨愈合。