同种异体骨-中13髌腱-骨、骨-跟腱移植重建羊膝关节后交叉韧带的比较研究

Comparative study on reconstruction of posterior cruciate ligament using bone-1/3 patellar tendon-bone and bone-Achilles tendon allografts

目的 对同种异体骨 -中 1 3髌腱 -骨 (B -PT -B)、骨 -跟腱移植重建后交叉韧带(PCL)后的组织学演变及力学特性进行初步分析 ,以了解其临床应用的可行性及影响因素。 方法 选用健康成年羊 2 5只 ,A组为取材组 (5只 ) ,B、C组为实验组 (各 10只 ) ;分别以新鲜冷冻异体B -PT -B和异体骨 -跟腱移植重建PCL ,分别以健侧为自身对照组 ,采用形态学及生物力学手段、对术后 1个月和 6个月两组移植物 (供体 )重建PCL后的组织学演变及术后 6个月力学特性进行初步分析。 结果 常规组织学染色显示 :重建PCL 6个月后两种移植物与正常PCL结构相似 ;生物力学测试结果表明 ,同种异体骨 -跟腱移植重建后的PCL的抗拉伸强度比同种异体B -PT-B重建的PCL高 ,且具有与正常PCL接近的力学特性。 结论 同种异体骨 -跟腱移植重建的PCL具有与正常PCL接近的力学特性 ,更适合临床应用。

Objective To preliminarily analyze the histologic changes and mechanical characters after reconstruction of posterior cruciate ligament (PCL) using bone-1/3 patellar tenden-bone (B-PT-B) and bone-Achilles tendon allografts. Methods Twenty-five adult sheep were divided into three groups, ie, Group A (five sheep, materials harvesting group), Group B and Group C (10 sheep respectively, both as experimental groups). PCL reconstruction using fresh frozen B-PT-B and bone-Achilles tendon allografts was carried out in both Groups B and C. Histologic changes and mechanical characters were primarily assessed one and six months after PCL reconstruction by means of morphology and biomechanics. Results Routine histologic staining showed that the reconstructed PCL six months later was similar to the normal PCL in aspects of the structure and the mechanical characters. The biomechanical test proved that the tension of PCL reconstructed by bone-Achilles tendon allograft obtained similar mechanical characters and was stronger than that by B-PT-B allograft. Conclusion Bone-Achilles tendon allograft is more applicable clinically than B-PT-B allograft in PCL reconstruction.