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发育性髋关节发育不良中的圆韧带:其力学和组织学特性是否得以保留?

THE ROUND LIGAMENT IN DEVELOPMENTAL HIP DYSPLASIA: ARE ITS MECHANICAL AND HISTOLOGICAL PROPERTIES PRESERVED?

作者信息

Zuccon Alexandre, Pereira Hamilton DA Rosa, Santos Sérgio Alexandre Alcântara Dos, Felisbino Sérgio Luís, Junior Luís Antônio Justulin, Cataneo Daniele Cristina

机构信息

. Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Department of Surgery and Orthopedics, Botucatu, SP, Brazil.

. Associação de Assistência à Criança Deficiente (AACD), Department of Orthopedics, São Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2022 Jan 28;30(1):e235808. doi: 10.1590/1413-785220223001e235808. eCollection 2022.

Abstract

INTRODUCTION

During open surgical dislocated hip reduction, several anatomical structures, such as the round ligament, are approached. However, there is controversy over both the possibility of preserving the ligament and its functional importance.

MATERIALS AND METHODS

This experimental study used skeletally immature rabbits as a model for congenital hip dislocation. Thirty-six rabbits comprised the sample that was submitted to the round ligament analysis. The sample was stratified for analysis (biomechanics, zymography, histology, and immunohistochemistry). Statistical analysis compared the unstable side to the control side of each rabbit.

RESULTS

Biomechanical assays showed that the mean maximal strength of the round ligament on the unstable side was similar to that of the control side (p = 0.594), which was also the case with maximum deformation (p = 0.328). Histologically, there was a statistically significant increase in cellularity on the unstable side (p <0.001). Additionally, there was significantly greater collagen occupancy on the control side (p <0.001). Zymography revealed no significant difference in the amount of active metalloproteinase 2 (MMP-2) (p = 0.068).

CONCLUSIONS

Although histological analysis found evidence of significant changes in the RL in unstable hips, there were no significant differences in zymography, and no changes were observed in biomechanical tests.

摘要

引言

在开放性手术复位脱位髋关节时,会涉及到一些解剖结构,比如圆韧带。然而,对于保留该韧带的可能性及其功能重要性存在争议。

材料与方法

本实验研究使用骨骼未成熟的兔子作为先天性髋关节脱位的模型。36只兔子组成样本并接受圆韧带分析。样本进行分层分析(生物力学、酶谱分析、组织学和免疫组织化学)。统计分析比较每只兔子不稳定侧与对照侧。

结果

生物力学检测显示,不稳定侧圆韧带的平均最大强度与对照侧相似(p = 0.594),最大变形情况也是如此(p = 0.328)。组织学上,不稳定侧细胞数量有统计学意义的增加(p <0.001)。此外,对照侧的胶原蛋白占有率显著更高(p <0.001)。酶谱分析显示活性金属蛋白酶2(MMP - 2)的量没有显著差异(p = 0.068)。

结论

尽管组织学分析发现不稳定髋关节中圆韧带存在显著变化的证据,但酶谱分析没有显著差异,生物力学测试也未观察到变化。

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