Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Japan.
Department of Rehabilitation, Soka Orthopedics Internal Medicine, Soka, Japan.
Connect Tissue Res. 2022 Mar;63(2):138-150. doi: 10.1080/03008207.2021.1889529. Epub 2021 Mar 4.
The healing ability of the anterior cruciate ligament (ACL) injury is very poor; however, it has recently been shown to undergo self-healing with conservative treatments. In this study, we evaluated the influence of the site of injury on the healing process after complete transverse tear of ACL using a rat model.
A total of 58 skeletally mature Wistar rats were randomly assigned to various ACL injury groups: controlled abnormal movement-mid-portion (CAM-MP), controlled abnormal movement-femoral side (CAM-FS), ACL transection-mid-portion (ACLT-MP), or ACL transection-femoral side (ACLT-FS) injury groups. The ACL was completely transected in the mid-portion in the ACLT-MP and CAM-MP groups, and on the femoral side in the ACLT-FS and CAM-FS groups. Both CAM groups underwent extra-articular braking to control for abnormal tibial translation. The animals were allowed full cage activity until sacrifice postoperatively for histological and biomechanical assessment.
Significant differences were found in the ratios of residual ligament lengths between the CAM-MP and CAM-FS groups, demonstrating the validity of each model. Spontaneous healing of the injured ACL was observed in the CAM-MP and CAM-FS groups but not in the ACLT-MP and ACLT-FS groups. The mechanical strength of the healing ACL did not differ between the CAM-MP and CAM-FS groups 8 weeks after injury; however, the former had better mechanical strength than the latter 12 weeks after the injury.
ACL injuries in the mid-portion and on the femoral side may be treated with conservative therapy for spontaneous healing.
前交叉韧带(ACL)损伤的愈合能力非常差;然而,最近的研究表明,在保守治疗下,ACL 可以自行愈合。在这项研究中,我们使用大鼠模型评估 ACL 完全横断撕裂后损伤部位对愈合过程的影响。
共 58 只骨骼成熟的 Wistar 大鼠被随机分配到各种 ACL 损伤组:控制异常运动-中部(CAM-MP)、控制异常运动-股骨侧(CAM-FS)、ACL 切断-中部(ACLT-MP)或 ACL 切断-股骨侧(ACLT-FS)损伤组。在 ACLT-MP 和 CAM-MP 组中,ACL 在中部完全切断,在 ACLT-FS 和 CAM-FS 组中,ACL 在股骨侧切断。CAM 两组均采用关节外制动来控制胫骨异常平移。动物在术后允许完全笼内活动,直至进行组织学和生物力学评估。
CAM-MP 和 CAM-FS 组之间的残留韧带长度比有显著差异,证明了每种模型的有效性。在 CAM-MP 和 CAM-FS 组中观察到受伤 ACL 的自发愈合,但在 ACLT-MP 和 ACLT-FS 组中未观察到。受伤后 8 周,CAM-MP 和 CAM-FS 组之间愈合 ACL 的力学强度没有差异;然而,前者在受伤后 12 周的机械强度优于后者。
ACL 中部和股骨侧的损伤可能可以通过保守治疗来促进自发愈合。