在不同时间点对兔行前交叉韧带重建术对骨道扩大的影响分析

Effect of anterior cruciate ligament reconstruction on bone tunnel enlargement in rabbits at different time

目的观察在不同时间点对兔行前交叉韧带(ACL)重建术对其骨道扩大的影响。方法将80只5~6个月龄新西兰白兔随机分为4组,每组20只,均行右侧膝关节ACL切断,制备ACL损伤动物模型,实验组动物分别于造模后2周(A组)、4周(B组)、8周(C组)采用自体半腱肌腱进行ACL重建术,对照组(D组)不用ACL重建。观察术后一般情况,实验组动物分别于术后4周、8周及12周时用CT三维重建观察胫骨骨道扩大情况。12周后处死4组动物,行大体观察、组织学评价。结果4组动物术后无关节感染、死亡情况,实验组跛行及抽屉实验阴性,对照组跛行及抽屉实验阳性。实验组骨道的扩大程度在术后4周时比较差异无统计学意义(P>0.05);术后8周、12周时,C组骨道扩大的程度均大于A、B组(P<0.05),A、B组间差异均无统计学意义(P>0.05)。大体观察,A、B组骨道口组织与正常韧带止点相同,C组有类似正常韧带止点结构,D组中12只动物ACL残端完全吸收。A、B组组织学评分高于C组(P<0.05),而A、B组间比较差异无统计学意义(P>0.05)。结论本研究表明,在ACL损伤早期行重建术,更有利于降低骨道的扩大。

Objective To explore the effect of anterior cruciate ligament(ACL)reconstruction on bone tunnel enlargement in rabbits at different time points.Methods 80 New Zealand white rabbits from 5~6 months-old were randomly divided into four groups(n=20),and the animal model of ACL injury was established underwent right knee ACL amputation in all rabbits.The experimental groups at two weeks(group A),four weeks(group B)and eight weeks(group C)after modeling,the ACL reconstruction operation with autogenous semitendinosus tendon.The control group(group D)did not undergo ACL reconstruction.The general condition was observed after operation,and the experimental groups of bone tunnel enlargement was measured by CT reconstruction at four,eight and 12 weeks.At eight weeks after operation in the experimental groups were sacrificed for gross observation and histological evaluation.Results No joint infection and death rabbits were found in the four groups after operation,and no claudication and drawer test were found in the experimental groups after operation,the control group showed claudication and drawer test.There were no significant differences in the enlargement of bone tunnel among with the experimental groups at four weeks after operation(P>0.05).At eight weeks and 12 weeks after operation,the degree of bone tunnel enlargement in group C was greater than that in group A and group B(P<0.05),and there were no significant differences between group A and group B(P>0.05).In term of general condition,the tissue at the mouth of bone tunnel in group A and group B was the same as that of normal ligamentous attachment point,and Group C was similar to normal ligament attachment point,the ACL stump was completely absorbed in twelve animals in group D else.In term of histological evaluation,the histological scores of group A and B were higher than those of group C(P<0.05),and there were no significant differences between group A and group B(P>0.05).Conclusion In this study,reconstruction in the early stage of ACL injury is more conducive to reduce the enlargement of bone tunnel.