Jackson D W, Grood E S, Goldstein J D, Rosen M A, Kurzweil P R, Cummings J F, Simon T M
Southern California Center for Sports Medicine, Long Beach Memorial Medical Center.
Am J Sports Med. 1993 Mar-Apr;21(2):176-85. doi: 10.1177/036354659302100203.
Similar-sized patellar tendon autografts and fresh-frozen allografts were used to reconstruct the anterior cruciate ligament of one knee in 40 female goats. Evaluations of the reconstructions and contralateral controls at the 6-week and 6-month postoperative periods included anterior-posterior translation, mechanical properties determined during tensile failure tests, measurement of cross-sectional area, histology, collagen fibril size and area distribution, and associated articular cartilage degenerative changes. Six months after anterior cruciate ligament reconstruction, the autografts demonstrated a smaller increase in anterior-posterior displacement, values of maximum force to failure two times greater, a significant increase in cross-sectional area, a more rapid loss of large-diameter collagen fibrils, and an increased density and number of small-diameter collagen fibrils compared to the allografts. Clinical significance. More surgeons are allowing their patients to return to running and sports 6 months after anterior cruciate ligament reconstruction. While the structural and material properties of autografts and allografts at time zero are similar, in the goat model during the first 6 months they differ. The allografts demonstrate a greater decrease in their implantation structural properties, a slower rate of biologic incorporation, and the prolonged presence of an inflammatory response. At 6 months the autograft demonstrates a more robust biologic response, improved stability, and increased strength to failure values.
在40只雌性山羊中，使用大小相似的髌腱自体移植物和新鲜冷冻同种异体移植物重建一侧膝关节的前交叉韧带。术后6周和6个月时对重建情况及对侧对照进行评估，内容包括前后向平移、拉伸破坏试验中测定的力学性能、横截面积测量、组织学、胶原纤维大小和面积分布以及相关的关节软骨退变变化。前交叉韧带重建6个月后，与同种异体移植物相比，自体移植物在前后向位移方面的增加较小，破坏时的最大力值大两倍，横截面积显著增加，大直径胶原纤维的损失更快，小直径胶原纤维的密度和数量增加。临床意义。越来越多的外科医生允许患者在前交叉韧带重建6个月后恢复跑步和运动。虽然自体移植物和同种异体移植物在初始时的结构和材料特性相似，但在山羊模型中，前6个月它们有所不同。同种异体移植物植入后的结构特性下降更大，生物整合速率较慢，炎症反应持续时间较长。6个月时，自体移植物表现出更强的生物反应、更好的稳定性和更高的破坏强度值。
