Claes L, Dürselen L, Kiefer H, Mohr W
Department of Surgery, University of Ulm, West Germany.
J Biomed Mater Res. 1987 Dec;21(A3 Suppl):319-43.
On 30 sheep, a combined replacement of the anterior cruciate and medial collateral ligament of the right knee was performed with four different materials. Dacron prostheses and glutaraldehyde-preserved bovine tendon prostheses as well as braided ligament prostheses made of carbon fibers and braided resorbable polydioxanone fibers surrounded by lyophilized dura in their intra-articular part were used. Ten unoperated sheep served as a control group. After 1 year the animals were sacrificed and the knee joints were explanted and biomechanically as well as histomorphologically investigated. The gross inspection of the joints showed no ruptured medial collateral ligament replacement but did show partially and totally ruptured anterior cruciate ligament replacements. The Dacron prosthesis was broken in 50% of the cases, whereas for the other materials one ruptured ligament replacement each (12.5%) could be observed. The anterior drawer test and the determination of the tensile stiffness of the remaining ligament replacements revealed that none of the operated knees achieved the properties of the normal control knees. However, the carbon fiber implants had the best result of all prostheses tested. For all materials except the resorbable polydioxanone, abrasion particles could be found in the anterior cruciate ligament and in the synovial membrane. The tissue reaction to these particles was a mild synovitis for carbon fragments, a strong synovitis for Dacron particles, and a chronic inflammatory response to bovine tendon fragments with macrophage granulomas and fibrosis.
对30只绵羊的右膝进行了前交叉韧带和内侧副韧带的联合置换，使用了四种不同的材料。使用了涤纶假体、戊二醛保存的牛肌腱假体，以及由碳纤维编织而成且在关节内部分被冻干硬脑膜包裹的可吸收聚二氧六环酮纤维编织韧带假体。10只未手术的绵羊作为对照组。1年后处死动物，取出膝关节并进行生物力学和组织形态学研究。关节的大体检查显示内侧副韧带置换物未破裂，但前交叉韧带置换物有部分和完全破裂的情况。涤纶假体在50%的病例中断裂，而其他材料各有1例韧带置换物破裂（12.5%）。前抽屉试验和剩余韧带置换物拉伸刚度的测定表明，所有手术膝关节均未达到正常对照膝关节的性能。然而，在所有测试的假体中，碳纤维植入物的效果最佳。除了可吸收聚二氧六环酮外，在所有材料的前交叉韧带和滑膜中都发现了磨损颗粒。组织对这些颗粒的反应是，对碳碎片为轻度滑膜炎，对涤纶颗粒为重度滑膜炎，对牛肌腱碎片为慢性炎症反应，伴有巨噬细胞肉芽肿和纤维化。
