Li Chun-Bao, Xue Chao, Qi Wei, Wang Ning, Xue Jing, Wu Xiao-Yong, Zhu Juan-Li, Liu Yang, Liu Yu-Jie
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China;
Zhongguo Gu Shang. 2017 Jun 25;30(6):538-544. doi: 10.3969/j.issn.1003-0034.2017.06.011.
To explore highly agglutinative staphylococcin (HAS) pomoting on tendon-bone healing after reconstruction of anterior cruciate ligament(ACL) in rabbits.
Animal model of ACL reconstruction in 24 mature New Zealand white rabbits(3 months, 2.56 kg on average, either gender) were established using autologous digital long extensor tendon and randomly classified into 2 groups(HAS and control group), 12 rabbits for each group. HAS group was separately injected 0.1ml highly agglutinative staphylococcin immediately into tendon-bone interface during the operation and 2 days after operation. Control group was injected with the same dose of physiological saline for 3 days. All animals were sacrificed at 4, 8, and 12 weeks after operation for histological examinations. The specimens were stained with hematoxylin-eosin, picric acid-sirius red, VEGF immunohistochemistry stain, and toluidine blue to histologically analysis the total pathology changes of the tendon-bone healing tissue, the tendon bone interface morphology classification, hyperplasia and arrangement of collagen fiber, vascularization and new bone formation, respectively.
The Yamakado morphological interface results showed that the tissue healing at tendon-bone interface of the HAS group was better than that of the control group. The histological examination revealed that on the 4th week after operation, the tendon-bone interface of HAS group was filled with fibrous connective tissue. The proliferated fibroblasts, chondroblasts and the angiogenesis were rich. On the 8th week after operation, the healing tissue at the bone-tendon interface had developed into dense connective tissue, the neo-vessels were very rich, the collagen fibers were formed abundantly, some Sharpey's fibers spanning parts of the tendon-bone interface. On the 12th week after operation, the transition zones were full of Sharpey's fibers;the neo-vessels were not as much as the 8th weeks, but new bone formation was further increased and immature fibrocartilage appeared. For quantitative histological analysis at 4, 8 and 12 weeks after operation, the proportion of neo-vessel area and the area of now bone formation of the HAS group were all significantly higher than those of the control group(<0.05).
Under the synergy of staphylococcal enterotoxin C and other active ingredients, Highly Agglutinative Staphylococcin can significantly improve the tendon-bone healing after ACL reconstruction in rabbit knees, which is expected to be a new method to improve the clinical results of ACL reconstruction.
探讨高聚集性葡萄球菌素（HAS）对兔前交叉韧带（ACL）重建术后腱骨愈合的促进作用。
采用自体趾长伸肌腱为24只成年新西兰白兔（3月龄，平均体重2.56 kg，雌雄不限）建立ACL重建动物模型，并随机分为2组（HAS组和对照组），每组12只。HAS组在手术中及术后2天分别于腱骨界面注射0.1ml高聚集性葡萄球菌素。对照组注射相同剂量生理盐水，共3天。所有动物分别于术后4、8、12周处死，进行组织学检查。标本分别行苏木精-伊红染色、苦味酸-天狼星红染色、VEGF免疫组化染色及甲苯胺蓝染色，分别从组织学上分析腱骨愈合组织的总体病理变化、腱骨界面形态分级、胶原纤维增生及排列、血管化及新骨形成情况。
Yamakado形态学界面结果显示，HAS组腱骨界面组织愈合情况优于对照组。组织学检查显示，术后4周，HAS组腱骨界面充满纤维结缔组织，增殖的成纤维细胞、软骨细胞及血管生成丰富。术后8周，骨腱界面愈合组织发展为致密结缔组织，新生血管非常丰富，胶原纤维大量形成，部分Sharpey纤维跨越腱骨界面。术后12周，移行区充满Sharpey纤维；新生血管不如8周时多，但新骨形成进一步增加，出现未成熟纤维软骨。术后4、8、12周进行组织学定量分析，HAS组新生血管面积及新骨形成面积所占比例均显著高于对照组（<0.05）。
在葡萄球菌肠毒素C等活性成分的协同作用下，高聚集性葡萄球菌素可显著促进兔膝关节ACL重建术后腱骨愈合，有望成为改善ACL重建临床效果的新方法。
