骨形态发生蛋白对自体月国绳肌腱重建前交叉韧带后腱-骨愈合影响的生物力学研究

Biomechanical study on effect of bone morphorgenetic protein on tendon-bone healing after anterior cruciate ligament reconstruction with autogenous tendon graft

目的研究骨形态发生蛋白(bone morphorgenetic protein,BMP)对自体月国绳肌腱重建前交叉韧带后腱-骨愈合的影响,旨在为临床上提高肌腱移植物成活质量提供一种新方法。方法取35只成年新西兰大白兔,建立30只两只膝关节前交叉韧带(anterior cruciate ligament,ACL)完全断裂的自身对照模型。实验组用BMP充填胫骨隧道入口,对照组未用BMP。其余5只为生物力学试验的正常组。术后2、4、8、12和24周分别安乐处死6只新西兰大白兔。肉眼观察肌腱移植物生长情况及在胫骨隧道内的愈合情况,生物力学拉伸试验测定其生物力学的性能。结果2、4、8和12周实验组肌腱移植物较对照组抗拉伸的最大载荷明显要大,差异有显著性(P<0.05);24周实验组肌腱移植物较对照组抗拉伸的最大载荷稍大,差异无显著性(P>0.05);24周实验组及对照组肌腱移植物抗拉伸的最大载荷均比正常组要小,差异有显著性(P<0.05)。结论实验组肌腱移植物的生物力学特性优于对照组肌腱移植物;BMP能促进肌腱移植物在骨隧道内的早期腱-骨愈合。

[Objective] To search a new way of improving the survival quality of tendon graft after anterior cruciate ligament reconstruction. We successfully set up the New Zealand rabbit model and studied the effect of bone morphorgenetic protein （BMP） on tendon-bone healing with autogenous tendon graft. [Methods] Thirty-five New Zealand rabbit were used in this study. Anterior cruciate ligaments of two knee joints were completely incised to create own control model of anterior cruciate ligament （ACL） rupture in thirty rabbits, and the rest was seleced as normal specimens in biomechanics testing. The entrances of tibial tunnel was filled with BMP in experiment group, but control group didn＇t recieve this treatment. Every 6 animals were enthanised as scheduled groups 2, 4, 8, 12, 24 weeks at postoperation. [Results] On 2, 4, 8, 12 weeks, the maximum load of failure of experiment group was sig- nificantly greater than control group, and it had significance （P 〈0.05）; On 24 weeks, the maximum load of failure of experiment group was slighdy greater than control group, but it did not have significance（P 〉0.05）; On 24 weeks, the maximum loads of failure of experiment group and control group were both smaller than normal group, but it had significance （P 〈0.05）. [Conclusions] Biomachanical property and insertion constructure in experiment were superior to control group; 2.BMP can improve the early tendon-bone healing in intra-articular model.