Negrín Roberto, Duboy Jaime, Olavarría Fernando, Wainer Mauricio, Jimenez Horacio, Las Heras Facundo, Reyes Nicolas, Godoy Hugo
Department of Orthopaedics and Traumatology, Clinica Las Condes, Lo Fontecilla 196, Santiago, 7591018, Chile.
Department of Pathology, Clinica Las Condes, Lo Fontecilla 196, Santiago, 7591018, Chile.
J Exp Orthop. 2016 Dec;3(1):20. doi: 10.1186/s40634-016-0056-2. Epub 2016 Sep 6.
Medial patellofemoral ligament (MPFL) is the main restrictor of lateral shifting of the patella, contributing by 60 % in the first 20° flexion of the knee. MPFL reconstruction has been performed in order to restore the stability of the patella with good results.Lyophilized Gracilis tendon allograft (LGA) compared to Cryopreserved Gracilis tendon allograft (CGA) has a lower cost, does not require to maintain cooling chain or preparation. The purpose of this study is to compare the histological and biomechanical characteristics of an experimental model of reconstruction of the MPFL in porcine patellas with LGA versus CGA.
Randomized controlled experimental study in porcine model conducted on 36 porcine patellas in which 18 were intervened with LGA and 18 were intervened with CGA. The confluent tunnel technique was used for MPFL reconstruction. Maximum tensile force, allograft elongation and stiffness of the construct were measured. The cellularity and collagen tissue distribution were evaluated in the allografts. The histological and biomechanical characteristics of the LGA were compared to those of the CGA.
The median of the maximum tensile force for the LGA group was 299.63 N and 280.86 N for the CGA group (p = 0.45). The median of the stiffness was 57.86 N/mm for the LGA and 54.23 N/mm for the CGA (p = 0.2). The median of the elongation for the LGA was 5.95 mm and 6.12 mm for the CGA (p = 0,29). The bone bridge failed in 88.88 % of the constructs with LGA and 94.44 % in those with CGA (p = 0.5).
No differences were observed between the LGA group and the CGA group in maximum tensile force, elongation, stiffness, site of rupture and histological characteristics. The use of a lyophilized Gracilis tendon allograft for MPFL reconstruction confers the same histological and biomechanical characteristics as a cryopreserved Gracilis tendon allograft.
髌股内侧韧带（MPFL）是髌骨外侧移位的主要限制因素，在膝关节最初20°屈曲时贡献达60%。已进行MPFL重建以恢复髌骨稳定性，效果良好。与冷冻保存的股薄肌腱同种异体移植物（CGA）相比，冻干股薄肌腱同种异体移植物（LGA）成本更低，无需维持冷链或进行制备。本研究的目的是比较猪髌骨MPFL重建实验模型中LGA与CGA的组织学和生物力学特征。
在猪模型上进行随机对照实验研究，对36个猪髌骨进行实验，其中18个用LGA干预，18个用CGA干预。采用汇合隧道技术进行MPFL重建。测量构建物的最大拉伸力、同种异体移植物伸长率和刚度。评估同种异体移植物中的细胞密度和胶原组织分布。将LGA的组织学和生物力学特征与CGA的进行比较。
LGA组最大拉伸力中位数为299.63 N，CGA组为280.86 N（p = 0.45）。LGA刚度中位数为57.86 N/mm，CGA为54.23 N/mm（p = 0.2）。LGA伸长率中位数为5.95 mm，CGA为6.12 mm（p = 0.29）。LGA构建物中88.88%的骨桥失败，CGA构建物中94.44%的骨桥失败（p = 0.5）。
LGA组和CGA组在最大拉伸力、伸长率、刚度、破裂部位和组织学特征方面未观察到差异。使用冻干股薄肌腱同种异体移植物进行MPFL重建具有与冷冻保存的股薄肌腱同种异体移植物相同的组织学和生物力学特征。
