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圆韧带撕裂对关节不稳定和关节软骨损伤发展的影响:一项兔体内研究

Effect of ligamentum teres tear on the development of joint instability and articular cartilage damage: an in vivo rabbit study.

作者信息

Baek Jong Hun, Chun Young Soo, Rhyu Kee Hyung, Yoon Wan Keun, Cho Yoon Je

机构信息

Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 23 Kyunghee-daero, Dongdaemun-gu, Seoul, 130-872, Korea.

Department of Orthopaedic Surgery, Graduate School, Kyung Hee University, Seoul, Korea.

出版信息

Anat Sci Int. 2018 Mar;93(2):262-268. doi: 10.1007/s12565-017-0406-x. Epub 2017 Jun 15.

Abstract

The contribution of the ligamentum teres to the stabilization of the hip joint and the clinical influence of a compromised ligamentum teres are not well known. This study aimed to investigate joint stability and cartilage damage in a rabbit model by surgically inducing a complete ligamentum teres tear. Twenty adult New Zealand rabbits were used in this study. Rabbits were divided into complete ligamentum teres tear with capsulotomy (n = 9, group I) and capsulotomy only (n = 10, group II) groups. Unilateral surgery was performed on the left hip. Joint instability was assessed by measuring the preoperative and postoperative acetabulofemoral (A-F) distances. Rabbits were euthanized to assess cartilage damage at 24 weeks postoperatively. The median postoperative A-F distance of the operated side in group I [0.68 cm (0.37-1.04 cm)] was larger than that in group II [0.50 cm (0.30-0.65 cm)] (p = 0.041). The median postoperative A-F distance was larger in the operated side [0.68 cm (0.37-1.04 cm)] compared to the nonoperated side [0.45 cm (0.30-0.75 cm)] in group I; it also was larger in the operated side [0.50 cm (0.30-0.65 cm)] compared to the nonoperated side [0.44 cm (0.32-0.67 cm)] in group II, but only group I showed a significant difference (p = 0.016 and 0.395, respectively). Articular cartilage damage was detected at the apex of the femoral head in two rabbits (22.2%) in group I only. Rabbits with a complete ligamentum teres tear showed significant instability at the hip joint and articular cartilage damage in our rabbit model, supporting the potential clinical importance of ligamentum teres as a hip joint stabilizer.

摘要

圆韧带对髋关节稳定性的贡献以及受损圆韧带的临床影响尚不明确。本研究旨在通过手术诱导兔圆韧带完全撕裂,来研究兔模型中的关节稳定性和软骨损伤情况。本研究使用了20只成年新西兰兔。将兔子分为圆韧带完全撕裂伴关节囊切开术组(n = 9,I组)和仅行关节囊切开术组(n = 10,II组)。对左侧髋关节进行单侧手术。通过测量术前和术后髋臼股骨(A-F)距离来评估关节稳定性。术后24周对兔子实施安乐死以评估软骨损伤情况。I组手术侧术后A-F距离中位数为[0.68 cm(0.37 - 1.04 cm)],大于II组的[0.50 cm(0.30 - 0.65 cm)](p = 0.041)。I组手术侧术后A-F距离中位数[0.68 cm(0.37 - 1.04 cm)]大于非手术侧[0.45 cm(0.30 - 0.75 cm)];II组手术侧术后A-F距离中位数[0.50 cm(0.30 - 0.65 cm)]也大于非手术侧[0.44 cm(0.32 - 0.67 cm)],但只有I组显示出显著差异(分别为p = 0.016和0.395)。仅在I组的两只兔子(22.2%)的股骨头顶端检测到关节软骨损伤。在我们的兔模型中,圆韧带完全撕裂的兔子表现出髋关节明显不稳定和关节软骨损伤,这支持了圆韧带作为髋关节稳定器的潜在临床重要性。

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