Engle C P, Noguchi M, Ohland K J, Shelley F J, Woo S L
Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania 15213.
J Orthop Res. 1994 May;12(3):357-64. doi: 10.1002/jor.1100120308.
The effects of healing time and anterior cruciate ligament reconstruction on healing of the medial collateral ligament and stability of the knee joint were evaluated in a rabbit model of an O'Donoghue triad injury (rupture of the medial collateral ligament with removal of the anterior cruciate ligament and part of the medial meniscus). At time 0 and at 6 and 12 weeks postoperatively, the anterior-posterior translation and varus-valgus rotation of the knee, the structural properties of the femur-medial collateral ligament-tibia complex, and the mechanical properties of the substance of the medial collateral ligament were evaluated. Although anterior-posterior translation increased significantly with time, we could not demonstrate a significant temporal effect on varus-valgus rotation. The ultimate load, elongation at failure, and energy absorbed to failure improved with time. In addition, with time, failure of the complex occurred more often in the ligament substance than at the osseous insertion. Because healing time did not affect the cross-sectional area or modulus of the medial collateral ligament, the improved structural properties of the complex resulted not from improvements in the mechanical properties of the tissue but rather from healing of the tibial insertion site. By 12 weeks, the reconstructed knees had only minor signs of osteoarthrosis on the tibiofemoral surfaces; this is in contrast to the findings in anterior cruciate ligament-deficient knees in our earlier study. Additionally, at 12 weeks, the stiffness of the complexes from the reconstructed group was 1.3 times that of the anterior cruciate ligament-deficient group (p < 0.05), and te ultimate load had increased by a factor of 1.6 (p < 0.05). Our findings demonstrate that reconstruction of the anterior cruciate ligament in the rabbit helps to stabilize the joint, improves healing of the medial collateral ligament, and may decrease the incidence of early-onset osteoarthrosis after an O'Donoghue triad injury.
在一个奥多诺休三联征损伤（内侧副韧带断裂并切除前交叉韧带和部分内侧半月板）的兔模型中，评估了愈合时间和前交叉韧带重建对内侧副韧带愈合及膝关节稳定性的影响。在术后0周、6周和12周时，评估了膝关节的前后平移和内外翻旋转、股骨 - 内侧副韧带 - 胫骨复合体的结构特性以及内侧副韧带实质的力学性能。尽管前后平移随时间显著增加，但我们未能证明其对内外翻旋转有显著的时间效应。极限负荷、破坏时的伸长以及破坏时吸收的能量随时间改善。此外，随着时间推移，复合体的破坏更多发生在韧带实质而非骨附着处。由于愈合时间不影响内侧副韧带的横截面积或模量，复合体结构性能的改善并非源于组织力学性能的改善，而是源于胫骨附着部位的愈合。到12周时，重建膝关节在胫股关节面仅有轻微的骨关节炎迹象；这与我们早期研究中前交叉韧带损伤膝关节的结果形成对比。此外，在12周时，重建组复合体的刚度是前交叉韧带损伤组的1.3倍（p < 0.05），极限负荷增加了1.6倍（p < 0.05）。我们的研究结果表明，兔的前交叉韧带重建有助于稳定关节，改善内侧副韧带的愈合，并可能降低奥多诺休三联征损伤后早期骨关节炎的发生率。
