股骨隧道角度对兔前交叉韧带重建术后骨隧道影响的初步探讨

PRELIMINARY STUDY ON EFFECT OF FEMORAL TUNNEL ANGLE ON FEMORAL TUNNEL AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN RABBITS

目的探讨不同股骨隧道角度对兔前交叉韧带（anterior cruciate ligament,ACL）重建术后骨隧道愈合的影响。方法取4-5月龄健康家兔54只（雌雄不限,体重1.8-2.3 kg）,随机分为3组（n=18）。3组均取右后肢自体跟腱制备ACL重建模型,重建时股骨隧道分别与股骨干纵轴在冠状位呈30、45、60°角定位;左膝关节作为正常对照。术后1、2、4周检测各组膝关节滑液中TNF-α含量,4、8、12周测量重建韧带最大载荷及骨隧道扩大率。结果与正常膝关节相比,3组术后各时间点膝关节滑液中TNF-α含量均显著增加,重建韧带最大载荷均降低,比较差异均有统计学意义（P〈0.05）;3组间比较差异均无统计学意义（P〉0.05）。3组术后各时间点均出现不同程度的股骨隧道扩大,4周时达最高值,但各时间点3组间股骨隧道扩大率比较,差异均无统计学意义（P〉0.05）。结论兔ACL重建中当股骨隧道与股骨干纵轴在冠状位呈30-60°间变化时,在早期对骨隧道愈合无明显影响。

Objective To investigate the effect of the femoral tunnel angle on the femoral tunnel after anterior cruciate ligament（ACL） reconstruction in rabbits. Methods Fifty-four healthy 4-5 months old rabbits（weighing, 1.8-2.3 kg, male or female） were randomly divided into 3 groups（n=18）. The ACL reconstruction models of the right knee were established in 3 experimental groups using its Achilles tendons, and the left knee served as the control group. On the coronal position, the angle between the femoral tunnel and the femoral shaft axis was 30°, 45°, and 60°. The level of tumor necrosis factor α（TNF-α） in the synovial fluid at 1, 2, and 4 weeks, the maximum load of the ligament and the rate of bone tunnel enlargement at 4, 8, and 12 weeks were detected. Results The level of TNF-α significantly increased, and the maximum load of the ligament significantly decreased in the 3 experimental groups when compared with ones in the control group（P〈0.05）, but no significant difference was found among 3 experimental groups（P〉0.05）. The bone tunnel enlargement was observed in 3 experimental groups at each time point and reached the peak at 4 weeks, but no significant difference was shown among 3 groups（P〉0.05）. Conclusion The 30-60° angle between the femoral tunnel and the femoral shaft axis in the coronal position has no significant effect on the femoral tunnel enlargement after ACL reconstruction in rabbits.