同种异体肌腱移植重建前交叉韧带的免疫排斥反应

Immune rejection following anterior cruciate ligament reconstruction with tendon allograft

背景:近年来同种异体肌腱移植逐渐用于治疗膝关节前交叉韧带损伤。目的:综述膝关节前交叉韧带损伤的特点及其同种异体肌腱移植重建后的免疫排斥反应问题。方法:应用计算机检索1990-01/2011-10PubMed数据库及维普数据库相关文献。英文检索词"anterior cruciate ligament,allograft,anatomy,transplantation",中文检索词"前交叉韧带,同种,肌腱,移植"。检索文献量总计164篇,最终纳入符合标准的文献34篇。结果与结论:国内外学者对同种异体肌腱移植重建前交叉韧带进行了几十年的研究,已逐步了解了膝关节前交叉韧带的生物力学特性;通过冷冻处理法、细胞毒物质处理法解决了同种异体肌腱移植后的免疫排斥反应,使其既能降低异体肌腱的抗原性,又能保存肌腱细胞的活性,促使肌腱的内源性愈合,提高肌腱愈合速度与强度,减轻或避免肌腱粘连的发生,临床应用取得了很好的效果。

BACKGROUND： In recent years, tendon allograft is gradually used for repair of anterior cruciate ligament injury. OBJECTIVE： To review the characteristics of anterior cruciate ligament injury and immune rejection following anterior cruciate ligament reconstruction with tendon allograft. METHODS： A computer-based search of PubMed and VIP databases （1990-01/2011-10） was performed for relevant articles using the keywords of ＂anterior cruciate ligament, allograft, anatomy, transplantation＂ in English and ＂anterior cruciate ligament, allograft, tendon, transplantation＂ in Chinese. Totally, 164 articles were retrieved, and finally 34 articles were included in result analysis. RESULTS AND CONCLUSION： Over the past several decades, domestic and foreign scholars have studied anterior cruciate ligament reconstruction with tendon allograft and gradually understood the biomechanical properties of the anterior cruciate ligament. Freezing method and cell toxic treatment method are employed to solve the immune rejection following allogeneic tendon grafting, not only to reduce the antigenicity of allogeneic tendon, but also to save the activity of tendon cells, promote endogenous tendon healing, improve tendon healing and strength, reduce or avoid the occurrence of tendon adhesions, and achieve good clinical results.