间歇性负压干预前交叉韧带重建后的腱-骨愈合

Intermittent negative pressure affects tendon-bone healing after anterior cruciate ligament reconstruction

背景:间歇性负压被证实可以促进软组织修复及骨愈合,但其对交叉韧带重建后腱-骨愈合的影响尚未见报道。目的:观察间歇性负压对兔前交叉韧带重建后腱-骨愈合及肌腱移植物生物力学的影响。方法:取24只新西兰大白兔制备自体半腱肌前交叉韧带重建模型,随机取一侧后腿作为负压侧,负压侧关节通过引流管接微型负压吸引器,并维持低强度、间歇性负压;对侧后腿作为对照,接普通引流管。5 d后两侧同时拔除吸引管。造模后6周,取关节液检测白细胞介素1β的表达水平;取股骨-韧带-胫骨复合体行肌腱移植物拉力测定和腱-骨界面组织学观察。结果与结论:1只兔关节感染,最终23只兔进入结果分析。拉力测定结果显示,负压组完全断裂所需拉力显著大于对照组(P<0.05)。组织学观察结果发现,负压组成骨细胞数目显著多于对照组,差异有显著性意义(P<0.01)。关节液检测结果提示负压组关节滑液中白细胞介素1β含量低于对照组,差异有显著性意义(P<0.01)。提示间歇性负压可能在前交叉韧带重建后腱-骨愈合、肌腱移植物的塑性过程中扮演着积极作用。

BACKGROUND： Intermittent negative pressure has been proven to promote the repairing of soft tissue and bone healing, but the effect of negative pressure on the tendon-bone healing after anterior cruciate ligament reconstruction has not been reported. OBJECTIVE： To research the effect of intermittent negative pressure on tendon-bone healing after anterior cruciate ligament reconstruction and on the biomechanics of tendon grafts. METHODS： A total of 24 New Zealand white rabbits were randomly selected to establish the models of anterior cruciate ligament reconstruction of autogenous semitendinosus. The hind leg of one side was selected randomly as the negative pressure group, and the joint of the negative pressure side was connected with the micro-negative pressure aspirator through drainage tube and maintained a low-intensity and intermittent negative pressure; the contralateral hind leg was as the control and connected with ordinary drainage tube. Drainage tubesof both sides were removed at the same time after 5 days. At 6 weeks after modeling, the joint fluid was drawn to detect the expression levels of intedeukin-1β; femur-ligament-tibia complex was used for tension measurement of tendon graft, and histological observation of tendon-bone interface. RESULTS AND CONCLUSION： One rabbit had joint infection, and finalty 23 rabbits were included in the study. Tension measurement results showed that maximum load for breakage in negative group pressure was significantly greater than that in the control group （P 〈 0.05）. Histological observation found that the number of osteoblasts in the negative pressure group was significantly more than that in the control group, and the difference was statistically significant （P 〈 0.01 ）. Detection of synovial fluid showed that itedeukin-1β content in synovial fluid of the negative pressure group was lower than that in the control group, and the difference was statistically significant （P 〈 0.01 ）. Intermittent negative pressure may play an active role in tendon-bone healing and modeling of tendon graft after anterior cruciate ligament reconstruction.