Amiel D, Billings E, Harwood F L
Division of Orthopaedics and Rehabiltation, University of California, San Diego, La Jolla 92093.
J Appl Physiol (1985). 1990 Sep;69(3):902-6. doi: 10.1152/jappl.1990.69.3.902.
To evaluate the protective role of the synovial sheath of the anterior cruciate ligament (ACL), we have developed a synovectomy model that exposes the ACL substance to the intra-articular environment with and without hemarthrosis. Histology and the level of collagenase activity were studied to assess intrinsic ligament alterations. The treatment groups studied were as follows: ACLs of sham-operated knees receiving arthrotomy only, ACLs of knees receiving arthrotomy and acute hemarthrosis, ACLs of knees that underwent synovectomy, and ACLs of knees that underwent both synovectomy and acute hemarthrosis. All animals were killed 10 days postoperatively for gross, histological, and biochemical assessment. Histologically at 10 days ACLs experiencing synovectomy and ACLs having synovectomy plus hemarthrosis revealed marked hypocellular areas. Biochemical results indicate that synovectomy is the treatment mainly responsible for the observed increase in ACL collagenase activity. Hemarthrosis alone clearly had no effect, although hemarthrosis coupled with synovectomy appeared to further increase the amount of active collagenase present in the ACLs. This study indicates that, with exposure of the ACL substance to the synovial fluid or with hemarthrosis after synovectomy, there is an increase in the degradative activity of the ACL. The protective role of the synovial sheath suggests that the synovial sheath injury associated with acute ACL rupture may allow for exposure of the ligament substance to the degradative effects of the synovial environment and associated hemarthrosis.
为评估前交叉韧带（ACL）滑膜鞘的保护作用，我们建立了一种滑膜切除术模型，该模型在有或无关节积血的情况下将ACL实质暴露于关节内环境。通过研究组织学和胶原酶活性水平来评估韧带的内在改变。所研究的治疗组如下：仅接受关节切开术的假手术膝关节的ACL、接受关节切开术和急性关节积血的膝关节的ACL、接受滑膜切除术的膝关节的ACL以及接受滑膜切除术和急性关节积血的膝关节的ACL。所有动物在术后10天处死，进行大体、组织学和生化评估。在术后10天的组织学检查中，经历滑膜切除术的ACL以及进行滑膜切除术加关节积血的ACL显示出明显的细胞减少区域。生化结果表明，滑膜切除术是导致观察到的ACL胶原酶活性增加的主要治疗因素。单独的关节积血显然没有影响，尽管关节积血与滑膜切除术相结合似乎进一步增加了ACL中活性胶原酶的含量。这项研究表明，当ACL实质暴露于滑液或滑膜切除术后出现关节积血时，ACL的降解活性会增加。滑膜鞘的保护作用表明，与急性ACL破裂相关的滑膜鞘损伤可能使韧带实质暴露于滑膜环境和相关关节积血的降解作用之下。
