Hildebrand K A, Woo S L, Smith D W, Allen C R, Deie M, Taylor B J, Schmidt C C
Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania 15213, USA.
Am J Sports Med. 1998 Jul-Aug;26(4):549-54. doi: 10.1177/03635465980260041401.
We report a biologic approach to improve medial collateral ligament healing using growth factors normally expressed in healing tissue. Our previous in vitro work demonstrated that platelet-derived growth factor-BB and transforming growth factor-beta 1 promoted fibroblast proliferation and matrix synthesis, respectively. There-fore, these growth factors were used in vivo to determine whether they could improve medial collateral ligament healing, whether this effect was dose-dependent, and if combinations of growth factors could improve healing more than individual growth factors. Thirty-seven rabbits had various doses of growth factors applied to the ruptured right medial collateral ligaments using a fibrin sealant delivery vehicle. The five groups consisted of 1) two groups receiving two doses of platelet-derived growth factor-BB, 2) two groups receiving two doses of this growth factor plus transforming growth factor-beta 1, and 3) one group receiving fibrin sealant only. After sacrifice at 6 weeks, biomechanical and histologic evaluations of the healing ligament were performed. Femur-medial collateral ligament-tibia complexes of the knees given the higher dose of platelet-derived growth factor-BB had ultimate load, energy absorbed to failure, and ultimate elongation values that were 1.6, 2.4, and 1.6 times greater than the same complexes of the control group. Adding transforming growth factor-beta 1 did not lead to any further increase in the structural properties of the complex compared with treatment with platelet-derived growth factor-BB. These encouraging results suggest that use of platelet-derived growth factor-BB may improve the quality of the healing medial collateral ligament, and that it may also have a similar potential for promoting healing of other ligaments.
我们报告了一种利用愈合组织中正常表达的生长因子来改善内侧副韧带愈合的生物学方法。我们之前的体外研究表明，血小板衍生生长因子-BB和转化生长因子-β1分别促进成纤维细胞增殖和基质合成。因此，这些生长因子被用于体内实验，以确定它们是否能改善内侧副韧带的愈合，这种效果是否具有剂量依赖性，以及生长因子组合是否比单一生长因子更能促进愈合。37只兔子的右侧内侧副韧带破裂处使用纤维蛋白密封剂递送载体施加了不同剂量的生长因子。五组分别为：1）两组接受两剂血小板衍生生长因子-BB；2）两组接受两剂该生长因子加转化生长因子-β1；3）一组仅接受纤维蛋白密封剂。6周后处死兔子，对愈合的韧带进行生物力学和组织学评估。接受较高剂量血小板衍生生长因子-BB的膝关节股骨-内侧副韧带-胫骨复合体的极限负荷、破坏时吸收的能量和极限伸长值分别是对照组相同复合体的1.6倍、2.4倍和1.6倍。与使用血小板衍生生长因子-BB治疗相比，添加转化生长因子-β1并未导致复合体的结构性能进一步提高。这些令人鼓舞的结果表明，使用血小板衍生生长因子-BB可能会改善内侧副韧带愈合的质量，并且它在促进其他韧带愈合方面可能也具有类似的潜力。
