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髌腱或人工韧带重建前交叉韧带对膝关节其他韧带形态的影响。犬类实验研究。

Effect of anterior cruciate ligament reconstruction with patellar tendon or prosthetic ligament on the morphology of the other ligaments of the knee joint. An experimental study in dogs.

作者信息

Järvinen M, Jozsa L, Johnson R J, Arms S, Beynnon B, Fischer R, Pope M H, Renström P

机构信息

Department of Surgery, Tampere University Hospital, Finland.

出版信息

Clin Orthop Relat Res. 1995 Feb(311):176-82.

PMID:7634573
Abstract

The effect of anterior cruciate ligament replacement on the other ligaments of the knee, including the medial or lateral collateral and posterior cruciate ligaments, was studied histologically in the canine knee. The anterior cruciate ligament was replaced either with the medial third of the patellar tendon or with a prosthetic ligament. Histologic analysis was performed 3 months after prosthetic ligament implantation and 1 year after patellar ligament reconstruction. In all ligaments, numerous pathologic alterations were found. Degenerative changes such as glycosaminoglycan accumulation, metachromasia, collagenolysis, collagen necrosis, and lipomatosis were similar after 3 months and after 1 year. Granulation tissue, a sign that characterizes tissue repair, was seen only in those ligaments taken 3 months after anterior cruciate ligament surgery. Similar degenerative changes also were found in the ligaments of the knees with only a large medial arthrotomy (sham). In the contralateral control knees, the pathologic alterations were rare. Thus, open arthrotomy alone or with anterior cruciate ligament reconstruction seems to result in longstanding degenerative changes in all ligaments of the canine knee joint.

摘要

在犬膝关节上,组织学研究了前交叉韧带置换对膝关节其他韧带的影响,这些韧带包括内侧或外侧副韧带以及后交叉韧带。前交叉韧带分别用髌腱内侧三分之一或人工韧带进行置换。在人工韧带植入后3个月以及髌韧带重建后1年进行组织学分析。在所有韧带中,均发现了大量病理改变。诸如糖胺聚糖积聚、异染性、胶原溶解、胶原坏死和脂肪化生等退行性变化在3个月后和1年后相似。肉芽组织是组织修复的特征性表现,仅在前交叉韧带手术后3个月取材的那些韧带中可见。在仅行大的内侧关节切开术(假手术)的膝关节韧带中也发现了类似的退行性变化。在对侧对照膝关节中,病理改变很少见。因此,单纯开放性关节切开术或联合前交叉韧带重建似乎会导致犬膝关节所有韧带出现长期的退行性变化。

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