LaPrade R F, Hamilton C D, Montgomery R D, Wentorf F, Hawkins H D
Department of Orthopaedic Surgery, University of Texas Medical Branch, Galveston, USA.
Am J Sports Med. 1997 Nov-Dec;25(6):779-85. doi: 10.1177/036354659702500609.
We assessed the histologic, mechanical, and structural properties of the reharvested central-third patellar tendon in greyhounds. Twelve dogs had the central third of the patellar tendon (5 mm) removed with corresponding bone blocks from the patella and tibia; the remaining tendon defect was loosely closed. Six dogs were sacrificed at 6 months and six at 12 months, and the central third of the patellar tendon was harvested from both the operative and the contralateral control knees. Analysis of the structural changes in the tendons revealed a significant increase in thickness for reharvested tendons at both 6 and 12 months when compared with controls. The entire residual tendons were narrower at 6 months and were shorter at 12 months compared with controls. Mechanical testing showed that the average failure load, ultimate tensile strength, strain at failure, and average modulus for the reharvested central third of the patellar tendon were significantly less than that of controls at both 6 and 12 months. Analysis of collagen fiber size by electron microscopy revealed a significant increase in collagen fiber diameter at 6 months (135 +/- 41 nm versus 49 +/- 4 nm) but no difference between the operative limbs and controls at 12 months. The reharvested bone-patellar tendon-bone complex does not have the same properties as the primary patellar tendon graft up to 1 year after harvest in a canine model, and its use for revision cruciate ligament reconstruction must be carefully reexamined.
我们评估了灵缇犬再次获取的髌腱中央三分之一部分的组织学、力学和结构特性。12只犬的髌腱中央三分之一部分（5毫米）连同髌骨和胫骨上相应的骨块被切除；剩余的肌腱缺损处松散缝合。6只犬在6个月时处死，6只在12个月时处死，从手术侧膝关节和对侧对照膝关节获取髌腱中央三分之一部分。对肌腱结构变化的分析显示，与对照组相比，再次获取的肌腱在6个月和12个月时厚度均显著增加。与对照组相比，整个残留肌腱在6个月时更窄，在12个月时更短。力学测试表明，再次获取的髌腱中央三分之一部分在6个月和12个月时的平均破坏载荷、极限拉伸强度、破坏应变和平均模量均显著低于对照组。通过电子显微镜对胶原纤维大小的分析显示，6个月时胶原纤维直径显著增加（135±41纳米对49±4纳米），但在12个月时手术侧肢体与对照组之间无差异。在犬模型中，再次获取的骨-髌腱-骨复合体在获取后长达1年的时间内并不具有与初次髌腱移植物相同的特性，其用于翻修交叉韧带重建必须仔细重新审视。
