膝关节前交叉韧带断裂对健侧膝关节软骨影响的实验研究

Effects of Unilateral Knee Anterior Cruciate Ligament Transection on Articular Cartilage of the Contralateral Knee of Rabbits

目的:研究膝关节前交叉韧带(ACL)断裂对健侧(contralateral,CL)膝关节软骨的影响。方法:30只成年新西兰大白兔(4~5月龄,体重2.5~3 kg),右膝为术侧,随机平均分为两组:ACL断裂组(ACLT/CL组)和假手术组(Sham/CL组),术后均在实验跑台上定期运动。运动开始于术后第5天,运动频率5天/周,10分钟/天,跑台速度0.3英里/小时(约8米/分钟)。分别于术后第18周、24周和36周每组处死5只兔子,获取对侧膝关节(左膝关节),对股骨内髁软骨进行大体观评分、组织学染色和二型胶原(COLⅡ)免疫组化染色并使用国际骨关节炎研究会(OARSI)软骨损伤评分系统进行软骨损伤评估。结果:Sham/CL组在各个时间点均未出现软骨损伤。ACLT/CL组在术后24周时可见软骨损伤,术后36周软骨损伤更加明显,并与Sham/CL组在大体观评分和OARSI评分上均有显著性统计学差异。结论:一侧膝关节ACL断裂后在较长期的日常运动条件下将造成健侧膝关节软骨损伤。临床上应重视膝关节ACL断裂后由于膝关节不稳对健侧膝关节整体的影响,尤其是软骨损伤。

Objective To explore the effect of unilateral anterior cruciate ligament transection(ACLT)on the articular cartilage of the contralateral(CL)knee of rabbits.Methods Thirty New Zealand white rabbits(4~5-month-old,2.5~3 kg)were randomly separated into an ACLT/CL group and a Sham/CL group.The ACLT/CL group was performed ACLT,while the Sham/CL group was given the sham operation.Five days after the surgery,both groups were forced to run on a treadmill,10 min a day at a speed of 0.3 mh(about 8 meters/min),5 days a week.At the 12 th,24 th and 36 th week after the surgery,5 rabbits from each group were sacrificed and their medial femur condyles from CL(left knees)were assessed through macroscopic observation and osteoarthritis research society international(OARSI)histological analysis,and the type Ⅱ collagen(COL Ⅱ)was tested using the immunochemical analysis.Results There were no significant cartilage lesions in Sham/CL group at different time points.However,the cartilage lesion appeared in the ACLT/CL group 24 weeks after the surgery and became more severe 12 week later.There were significant differences in the average macroscopic and OARSI scores between the two groups 24 and 36 weeks after the surgery.Conclusion The long-term unilateral ACL transection may cause articular cartilage injury of the contralateral knee and due attention should be paid to such condition in the clinical practice.