股骨骨隧道形态对前交叉韧带重建中腱骨愈合的影响：一项动物研究。

The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction: An animal study.

作者信息

Sato Y, Akagi R, Akatsu Y, Matsuura Y, Takahashi S, Yamaguchi S, Enomoto T, Nakagawa R, Hoshi H, Sasaki T, Kimura S, Ogawa Y, Sadamasu A, Ohtori S, Sasho T

机构信息

Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

Department of Orthopedic Surgery, Toho University Sakura Medical Center, Chiba, Japan.

出版信息

Bone Joint Res. 2018 Jun 5;7(5):327-335. doi: 10.1302/2046-3758.75.BJR-2017-0238.R2. eCollection 2018 May.

OBJECTIVES

To compare the effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament (ACL) reconstruction animal model.

METHODS

Anterior cruciate ligament reconstruction using the plantaris tendon as graft material was performed on both knees of 24 rabbits (48 knees) to mimic ACL reconstruction by two different suspensory fixation devices for graft fixation. For the adjustable fixation device model (Socket group; group S), a 5 mm deep socket was created in the lateral femoral condyle (LFC) of the right knee. For the fixed-loop model (Tunnel group; group T), a femoral tunnel penetrating the LFC was created in the left knee. Animals were sacrificed at four and eight weeks after surgery for histological evaluation and biomechanical testing.

RESULTS

Histologically, both groups showed a mixture of direct and indirect healing patterns at four weeks, whereas only indirect healing patterns were observed in both groups at eight weeks. No significant histological differences were seen between the two groups at four and eight weeks in the roof zone (four weeks, S: mean 4.8 sd 1.7, T: mean 4.5 sd 0.5, p = 0.14; eight weeks, S: mean 5.8 sd 0.8, T: mean 4.8 sd 1.8, p = 0.88, Mann-Whitney U test) or side zone (four weeks, S: mean 5.0 sd 1.2, T: mean 4.8 sd 0.4, p = 0.43; eight weeks, S: mean 5.3 sd 0.8,T: mean 5.5 sd 0.8, p = 0.61, Mann-Whitney U test) . Similarly, no significant difference was seen in the maximum failure load between group S and group T at four (15.6 sd 9.0N and 13.1 sd 5.6N) or eight weeks (12.6 sd 3.6N and 17.1 sd 6.4N, respectively).

CONCLUSION

Regardless of bone tunnel configuration, tendon-bone healing after ACL reconstruction primarily occurred through indirect healing. No significant histological or mechanical differences were observed between adjustable and fixed-loop femoral cortical suspension methods.: Y. Sato, R. Akagi, Y. Akatsu, Y. Matsuura, S. Takahashi, S. Yamaguchi, T. Enomoto, R. Nakagawa, H. Hoshi, T. Sasaki, S. Kimura, Y. Ogawa, A. Sadamasu, S. Ohtori, T. Sasho. The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction: An animal study. 2018;7:327-335. DOI: 10.1302/2046-3758.75.BJR-2017-0238.R2.

目的

在一个前交叉韧带（ACL）重建动物模型中，比较股骨骨隧道形态对腱骨愈合的影响。

方法

选取24只兔子（48个膝关节），对其双膝均采用跖肌腱作为移植物材料进行前交叉韧带重建，以模拟通过两种不同的悬吊固定装置进行的ACL重建。对于可调固定装置模型（套接组；S组），在右膝外侧股骨髁（LFC）创建一个5毫米深的套接。对于固定环模型（隧道组；T组），在左膝创建一个穿透LFC的股骨隧道。术后4周和8周处死动物，进行组织学评估和生物力学测试。

结果

组织学上，两组在4周时均显示直接愈合和间接愈合模式的混合，而在8周时两组均仅观察到间接愈合模式。在4周和8周时，两组在顶部区域（4周，S组：平均值4.8标准差1.7，T组：平均值4.5标准差0.5，p = 0.14；8周，S组：平均值5.8标准差0.8，T组：平均值4.8标准差1.8，p = 0.88，Mann-Whitney U检验）或侧面区域（4周，S组：平均值5.0标准差1.2，T组：平均值4.8标准差0.4，p = 0.43；8周，S组：平均值5.3标准差0.8，T组：平均值5.5标准差0.8，p = 0.61，Mann-Whitney U检验）均未观察到显著的组织学差异。同样，S组和T组在4周（分别为15.6标准差9.0N和13.1标准差5.6N）或8周（分别为12.6标准差3.6N和17.1标准差6.4N）时的最大破坏载荷也没有显著差异。

结论

无论骨隧道形态如何，ACL重建后的腱骨愈合主要通过间接愈合发生。在可调式和固定环式股骨皮质悬吊方法之间，未观察到显著的组织学或力学差异。：Y. 佐藤、R. 赤木、Y. 赤津、Y. 松浦、S. 高桥、S. 山口、T. 榎本、R. 中川、H. 星、T. 佐佐木、S. 木村、Y. 小川、A. 定正、S. 大取、T. 佐翔。股骨骨隧道形态对前交叉韧带重建中腱骨愈合的影响：一项动物研究。2018；7：327 - 335。DOI：10.1302/2046 - 3758.75.BJR - 2017 - 0238.R2