自体跟腱重建与聚乙烯对苯二酸酯人工韧带重建前交叉韧带在骨隧道内愈合情况的比较

发布时间：2018-04-28 12:54

本文选题：PET + 移植物骨愈合　；参考：《广东医学》2017年18期

【摘要】：目的对比自体跟腱重建前交叉韧带(ACL)与聚乙烯对苯二酸酯(PET)人工韧带重建ACL在骨隧道内愈合情况。方法选取36只6周龄新西兰大白兔,模仿临床上ACL重建方法,将自体跟腱(自体组)和PET人工韧带(PET组)植入新西兰大白兔右侧膝关节内。术后4、8及16周处死动物,获得股骨-移植物-胫骨复合物。对此复合物进行生物力学、病理学和分子生物学(mRNA测定,Western blot)测试。结果组织学检测上,与自体组比较,PET组移植物内部有较多的胶原纤维生成,没有发现新生的软骨组织。在实验设定的观察时间内(术后16周),两组在移植物内部均未发现骨组织新生。PET组移植物的拉出力在8周和16周时低于自体组(P=0.05)。两组在韧带内部mRNA检测发现自体组的骨钙素(OCN)、RUNX2、X型胶原蛋白的mRNA水平,在4周时两组差异无统计学意义(P=0.15,P=0.30和P=0.12),余各时间点各项检测mRNA,自体组均较PET组更高,差异有统计学意义(P=0.03,P=0.01和P=0.01)。骨隧道周围骨组织的Western blot检测中,自体组在各个时间点,OCN和X型胶原蛋白含量,自体组均高于PET组(P=0.02,P=0.03)。结论 PET韧带与自体跟腱移植物比较,在骨隧道内的愈合过程机制不同。PET韧带以胶原纤维长入为主,自体跟腱则发生了软骨组织的替代转化,并有进一步骨化的趋势。
[Abstract]:Objective to compare the healing of autogenous Achilles tendon anterior cruciate ligament (ACL) and polyethylene terephthalate (PET) artificial ligament (PET) artificial ligament (ACL) in bone tunnel. Methods 36 New Zealand white rabbits aged 6 weeks old were selected to imitate the clinical ACL reconstruction, and the autologous tendon (autologous group) and PET artificial ligament (group PET) were implanted into the right knee joint of New Zealand white rabbits. 4,8 and 16 weeks after the operation, the animals were killed and the femur graft tibial complex was obtained. Biomechanics, pathology and Molecular Biology (mRNA measurement, Western blot) test. Results the histological examination, compared with the autologous group, there were more collagen fibers in the group of the PET grafts and no new cartilaginous tissue was found. Within the observed time of observation (16 weeks after the operation), the two groups were not found in the new.PET group of the bone tissue in the two groups at 8 and 16 weeks. The two groups found the Osteocalcin (OCN) and the mRNA level of the RUNX2, X type collagen in the internal ligaments, and there was no statistical difference between two groups at 4 weeks. Meaning (P=0.15, P=0.30 and P=0.12), each time point detected mRNA, the autologous group was higher than the PET group, the difference was statistically significant (P=0.03, P=0.01 and P=0.01). In the Western blot detection of bone tissue around the bone tunnel, the autologous group was at every time point, OCN and X type collagen egg white content. Compared with autologous Achilles tendon graft, the mechanism of the healing process in the bone tunnel is different from the.PET ligaments in the collagen fibers, and the autogenous Achilles are replaced by cartilage tissue, and there is a trend of further ossification.

【作者单位】：河北医科大学第三医院康复科;
【基金】：国家自然科学基金青年基金项目(编号:31300898)
【分类号】：R318.08;R687.4

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