Department of Orthopedic and Trauma Surgery, Albert Ludwig University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2012 May;20(5):947-56. doi: 10.1007/s00167-011-1678-7. Epub 2011 Sep 28.
The structural properties of the healing ligament are the determining factor for the stability of the reconstruction before, during, and after osseous integration of anterior cruciate ligament grafts. Over the course of ligamentization, the stability of synovialized grafts seems lower than that of non-synovialized patellar tendon grafts.
In an animal study on 42 sheep, 21 non-synovialized grafts (patellar tendon) and 21 synovialized grafts (flexor digitorum superficialis tendon) were performed to replace the anterior cruciate ligament. After 6, 12, and 24 weeks, 7 animals from each group were euthanized and investigated. Anteroposterior stability of the knee was assessed. After removal of all other soft tissues, the ACL was loaded to failure. Histology and histological analysis of the intra-articular graft region was then performed.
There were no significant differences in the translation test comparing synovialized and non-synovialized grafts. After 6, 12, and 24 weeks, all transplants failed in the tensile test due to interligamentous rupture or avulsion. After 6 weeks, transplants did not show significant biomechanical differences. Load to failure and stiffness of the patellar tendon was more than twice those of synovialized tendon (P = 0.002) after 12 weeks. Histology revealed necrosis in patellar tendon specimens after 12 weeks. A significant increase in load to failure was determined in synovialized ligament grafts between 12 and 24 weeks (P = 0.005). Its load capacity then tended to be higher than that of patellar tendon grafts.
The stability of synovialized ligament grafts is significantly lower than that of non-synovialized patellar tendon grafts after 12 weeks. This difference is compensated after 24 weeks. The significantly lower load to failure of synovialized compared with non-synovialized grafts after 12 weeks may be clinically relevant for the rehabilitation process of anterior cruciate ligament grafts in humans.
在骨整合过程中，前交叉韧带移植物的愈合韧带的结构特性是重建稳定性的决定因素。在韧带化过程中，滑膜化移植物的稳定性似乎低于非滑膜化髌腱移植物。
在一项对 42 只绵羊的动物研究中，进行了 21 个非滑膜化移植物（髌腱）和 21 个滑膜化移植物（指浅屈肌腱）以替代前交叉韧带。每组 7 只动物在 6、12 和 24 周后被安乐死并进行研究。评估膝关节的前后稳定性。在去除所有其他软组织后，加载 ACL 直至失效。然后对关节内移植物区域进行组织学和组织学分析。
在滑膜化和非滑膜化移植物的翻译测试中，没有显著差异。在 6、12 和 24 周后，所有移植物在拉伸试验中均因韧带间断裂或撕脱而失效。6 周后，移植物的生物力学差异不明显。髌腱的失效载荷和刚度是滑膜化肌腱的两倍多（P = 0.002），12 周后。12 周后，髌腱标本的组织学显示坏死。滑膜化韧带移植物在 12 至 24 周之间的失效载荷显著增加（P = 0.005）。其承载能力随后趋于高于髌腱移植物。
12 周后，滑膜化韧带移植物的稳定性明显低于非滑膜化髌腱移植物。这种差异在 24 周后得到补偿。12 周后滑膜化与非滑膜化移植物相比，失效载荷显著降低，这可能与人类前交叉韧带移植物康复过程相关。
