Cook James L, Smith Pat, Stannard James P, Pfeiffer Ferris, Kuroki Keiichi, Bozynski Chantelle C, Cook Cristi
Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri.
Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.
J Knee Surg. 2017 Sep;30(7):704-711. doi: 10.1055/s-0036-1597618. Epub 2016 Dec 26.
Novel graft types, fixation methods, and means for augmenting anterior cruciate ligament (ACL) reconstructions require preclinical validation prior to safe and effective clinical application. The objective of this study was to describe and validate a translational canine model for all-inside arthroscopic complete ACL reconstruction using a quadriceps tendon allograft with internal brace (QTIB). With institutional approval, adult research hounds underwent complete transection of the native ACL followed by all-inside ACL reconstruction using the novel QTIB construct with suspensory fixation ( = 10). Contralateral knees were used as nonoperated controls ( = 10). Dogs were assessed over a 6-month period using functional, diagnostic imaging, gross, biomechanical, and histologic outcome measures required for preclinical animal models. Study results suggest that the novel QTIB construct used for complete ACL reconstruction can provide sustained knee stability and function without the development of premature osteoarthritis in a rigorous and valid preclinical model. The unique configuration of the QTIB construct-the combination of a tendon allograft with a synthetic suture tape internal brace-allowed for an effective biologic-synthetic load-sharing ACL construct. It prevented early failure, allowed for direct, four-zone graft-to-bone healing, and functional graft remodeling while avoiding problems noted with use of all-synthetic grafts.
新型移植物类型、固定方法以及增强前交叉韧带（ACL）重建的手段，在安全有效地应用于临床之前需要进行临床前验证。本研究的目的是描述并验证一种用于全关节镜下使用带内部支撑的股四头肌腱同种异体移植物（QTIB）进行完全ACL重建的转化犬模型。经机构批准，成年实验猎犬接受了天然ACL的完全横断，随后使用具有悬吊固定的新型QTIB构建体进行全关节镜下ACL重建（n = 10）。对侧膝关节用作未手术对照（n = 10）。在6个月的时间内，使用临床前动物模型所需的功能、诊断成像、大体、生物力学和组织学结果指标对犬进行评估。研究结果表明，在一个严格且有效的临床前模型中，用于完全ACL重建的新型QTIB构建体可以提供持续的膝关节稳定性和功能，而不会出现过早的骨关节炎。QTIB构建体的独特结构——同种异体肌腱与合成缝线带内部支撑的组合——形成了一种有效的生物-合成负载分担ACL构建体。它防止了早期失败，实现了移植物与骨的直接四区愈合以及功能性移植物重塑，同时避免了使用全合成移植物时出现的问题。
