Sabiston P, Frank C, Lam T, Shrive N
Joint Injury and Diseases Research Group, Faculty of Medicine, University of Calgary, Alberta, Canada.
J Orthop Res. 1990 Jan;8(1):35-45. doi: 10.1002/jor.1100080105.
This investigation was designed to study the biomechanical recovery of a free bone-ligament-bone graft that was returned to its normal extra-articular position, with as little disturbance to its mechanical and biological environments as possible. Twenty-five adult New Zealand white rabbits had their right bone-medial collateral ligament (MCL)-bone complex removed completely and replaced immediately using internal fixation. Animals were allowed unrestricted cage activity before sacrifice in groups of five at intervals of 3, 6, 12, 24, and 48 weeks posttransplantation. Contralateral legs served as internal controls and a separate series of normal animals served as external controls. All MCLs were tested biomechanically using a detailed testing protocol. Results showed early deterioration of 20-35% in autograft complex structural behavior, with weakening of both ligament substance and insertions. Viscoelastic behavior of these ligaments was also affected, showing increases in the amount of both cyclic load-relaxation and static load-relaxation at early healing intervals. These properties were statistically indistinguishable, however, from controls at 48 weeks. Failure behavior of autografts was even better preserved, reaching a low of 65% of control values at 24 weeks and recovering to within 10% of controls at 48 weeks. These results, plus the major changes in failure modes that occurred over that duration, suggest that autograft incorporation is a slow but dynamic process. These results further suggest that at least some connective tissue autografts, when placed under, as yet undefined, "proper biological and mechanical conditions," can retain and recover a number of biomechanical properties over a period of 1 year. The longer-term fate of these autografts and the exact nature of their similarities or differences from other graft alternatives (e.g., tendon for ligament), however, is unknown.
本研究旨在探讨将游离骨-韧带-骨移植物恢复至正常关节外位置时的生物力学恢复情况，同时尽可能减少对其力学和生物学环境的干扰。25只成年新西兰白兔的右侧骨-内侧副韧带（MCL）-骨复合体被完全切除，并立即使用内固定进行置换。在移植后3、6、12、24和48周，将动物按每组5只进行处死，处死前允许其在笼中自由活动。对侧腿作为内部对照，另一组正常动物作为外部对照。所有MCL均使用详细的测试方案进行生物力学测试。结果显示，自体移植复合体的结构行为在早期恶化了20%-35%，韧带实质和附着点均变弱。这些韧带的粘弹性行为也受到影响，在愈合早期，循环负荷松弛和静态负荷松弛的量均增加。然而，在48周时，这些特性在统计学上与对照组无显著差异。自体移植物的失效行为保存得更好，在24周时降至对照值的65%，在48周时恢复到对照值的10%以内。这些结果，加上在这段时间内失效模式的主要变化，表明自体移植物的整合是一个缓慢但动态的过程。这些结果进一步表明，至少一些结缔组织自体移植物，当置于尚未明确的“适当生物和力学条件”下时，在1年内可以保留并恢复一些生物力学特性。然而，这些自体移植物的长期命运以及它们与其他移植替代物（如韧带用肌腱）的异同的确切性质尚不清楚。
