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采用双股肌腱移植技术重建前交叉韧带:在兔身上的实验研究

Reconstruction of anterior cruciate ligament using the doubled tendon graft technique: an experimental study in rabbits.

作者信息

Papachristou G, Tilentzoglou A, Efstathopoulos N, Khaldi L

机构信息

Department of Orthopaedic Surgery, KAT Hospital, University of Athens Medical School, Greece.

出版信息

Knee Surg Sports Traumatol Arthrosc. 1998;6(4):246-52. doi: 10.1007/s001670050107.

Abstract

In an attempt to assess reconstruction of the anterior cruciate ligament (ACL) by a new method, 18 New Zealand white rabbits underwent ACL replacement using the medial one-third of the patellar tendon and the semitendinosus tendon, thus partly reproducing the anatomical configuration of the ACL, with the semitendinosus tendon replacing the posterolateral bundle of the ACL and the patellar tendon replacing the anteromedial bundle. The Noulis-Trillat-Lachman test was performed before and after transection of the ACL, after reconstruction and before sacrifice. The animals were divided into four groups and were killed at 3, 6, 12 and 22 weeks after surgery. Femur-ligament-tibia complexes were evaluated postoperatively for gross morphology and histological appearance. The tendons of the first group showed compact parallel fibres with no definitive separation of their bundles and areas of disorganized collagen matrix. Tendons were surrounded by trabecular lamellar bone haphazardly arranged. The tendons of the second, third and fourth groups looked more like normal tendon. The trabecular bone surrounding the tendons formed a tunnel. The Noulis-Trillat-Lachman test result was negative before the procedure, 6.5 +/- 0.5 mm on average after transection of the ACL, 1.5 +/- 0.6 mm after the procedure, and negative again before sacrifice. The joints of the animals killed at 12 and 22 weeks showed signs of osteoarthritic lesions.

摘要

为了评估一种新方法重建前交叉韧带(ACL)的效果,18只新西兰白兔接受了使用髌腱内侧三分之一和半腱肌肌腱进行的ACL置换,从而部分重现了ACL的解剖结构,其中半腱肌肌腱替代ACL的后外侧束,髌腱替代前内侧束。在ACL横断前、重建后及处死前进行Noulis-Trillat-Lachman试验。将动物分为四组,分别在术后3、6、12和22周处死。术后对股骨-韧带-胫骨复合体进行大体形态和组织学外观评估。第一组的肌腱显示紧密平行的纤维,其束之间没有明确的分离,且存在胶原基质紊乱区域。肌腱被杂乱排列的小梁状板层骨包围。第二、第三和第四组的肌腱看起来更像正常肌腱。肌腱周围的小梁骨形成一个隧道。术前Noulis-Trillat-Lachman试验结果为阴性,ACL横断后平均为6.5±0.5mm,术后为1.5±0.6mm,处死前再次为阴性。在12周和22周处死的动物关节显示出骨关节炎病变的迹象。

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