Sakane Masataka, Mutsuzaki Hirotaka, Hattori Shinya, Nakajima Hiromi, Ochiai Naoyuki
Department of Orthopaedic Surgery, Institute of Clinical Medicine, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan.
Sports Med Arthrosc Rehabil Ther Technol. 2009 Dec 10;1(1):27. doi: 10.1186/1758-2555-1-27.
The purpose of this study is to clarify the differences in time-dependent histological changes (chondrocyte apoptosis and glycosaminoglycan (GAG) layer thickness decrease) between uncalcified fibrocartilage (UF) and calcified fibrocartilage (CF) layers at the anterior cruciate ligament (ACL) insertion after ACL resection of rabbits.
Forty male Japanese white rabbits underwent ACL substance resection in the right knee (resection group) and same operation without resection in the left knee (sham group). Animals were sacrificed 1, 2, 4 and 6 weeks after surgery.
In the UF layer, the apoptosis rate in the resection group was significantly higher than that in the sham group at 1 and 2 weeks. The GAG layer thicknesses of the UF layer in the resection group at 1, 2, 4 and 6 weeks were lower than those in the sham group. In the CF layer, the apoptosis rate in the resection group was significantly higher than that in the sham group at 2 and 4 weeks. The GAG layer thickness of the CF layer in the resection group was lower than that in the sham group only at 6 weeks.
The increase in chondrocyte apoptosis rate preceded the decrease in GAG layer thickness in both layers. In the UF layer, the increase in chondrocyte apoptosis rate and the decrease in GAG layer thickness preceded those in the CF layer. Using a surviving ligament and minimizing a debridement of ACL remnant during ACL reconstruction may be important to maintain cartilage layers of ACL insertion. An injured ACL should be repaired before degenerative changes of the insertion occur.
本研究的目的是阐明兔前交叉韧带(ACL)切除术后,ACL止点处未钙化纤维软骨(UF)层和钙化纤维软骨(CF)层随时间变化的组织学改变(软骨细胞凋亡和糖胺聚糖(GAG)层厚度降低)的差异。
40只雄性日本白兔右侧膝关节行ACL实质切除(切除组),左侧膝关节行相同手术但不切除ACL作为对照(假手术组)。术后1、2、4和6周处死动物。
在UF层,切除组在术后1周和2周时的凋亡率显著高于假手术组。切除组在术后1、2、4和6周时UF层的GAG层厚度均低于假手术组。在CF层,切除组在术后2周和4周时的凋亡率显著高于假手术组。切除组CF层的GAG层厚度仅在术后6周时低于假手术组。
两层中软骨细胞凋亡率的增加均先于GAG层厚度的降低。在UF层,软骨细胞凋亡率的增加和GAG层厚度的降低先于CF层。在ACL重建术中保留残留韧带并尽量减少ACL残端的清理,对于维持ACL止点处的软骨层可能很重要。受伤的ACL应在止点发生退变之前进行修复。