Dürselen L, Claes L, Ignatius A, Rübenacker S
Abteilung Unfallchirurgische Forschung und Biomechanik (Department of Orthopaedic Research and Biomechanics), University of Ulm, Germany.
Biomaterials. 1996 May;17(10):977-82. doi: 10.1016/0142-9612(96)84671-0.
Three different ligament prostheses (Leeds-Keio, Gore-Tex and a prototype of Aramid) were implanted in sheep knee joints replacing the anterior cruciate ligament and the medial collateral ligament. After 1 yr the knees were explanted and their biomechanical properties were assessed by a drawer test and tensile tests of the implants. Additionally the ligament replacements, the synovial membrane and the lymph nodes were inspected histologically. For each type of prosthesis partial or total ruptures occurred. None of the operated joints regained normal stability and stiffness. Anterior knee stability was best for the Gore-Tex treated group and worst for those joints that received a Leeds-Keio implant. The stiffness and rupture strength were highest for the Gore-Tex prostheses. Histologically the strongest intra-articular inflammatory response was observed in the Gore-Tex treated joints. Inside the drill tunnels the severest foreign body reaction was found for the Aramid prostheses. Gore-Tex fibres often showed good bony integration. Wear particles formed from all prostheses and caused small granulomas and mild synovities. The results suggest that none of the tested materials represent an ideal solution for ligament replacement. Relatively good stability does not guarantee good biocompatibility and vice versa. This suggests that ligament prostheses should be applied only in salvage cases.
将三种不同的韧带假体（利兹 - 庆应义塾、戈尔特斯和一种芳纶原型）植入绵羊膝关节，以替代前交叉韧带和内侧副韧带。1年后取出膝关节，通过抽屉试验和对植入物的拉伸试验评估其生物力学性能。此外，对韧带替代物、滑膜和淋巴结进行组织学检查。每种类型的假体都出现了部分或完全断裂。没有一个手术关节恢复到正常的稳定性和刚度。对于接受戈尔特斯治疗的组，膝关节前侧稳定性最佳，而对于接受利兹 - 庆应义塾植入物的关节，稳定性最差。戈尔特斯假体的刚度和断裂强度最高。组织学上，在接受戈尔特斯治疗的关节中观察到最强的关节内炎症反应。在钻孔隧道内，芳纶假体的异物反应最为严重。戈尔特斯纤维通常显示出良好的骨整合。所有假体都会形成磨损颗粒，并导致小肉芽肿和轻度滑膜炎。结果表明，所测试的材料都不能代表韧带替代的理想解决方案。相对良好的稳定性并不能保证良好的生物相容性，反之亦然。这表明韧带假体仅应在挽救性病例中应用。
