CAJ | 학술논문

背景:前交叉韧带断裂后应用自体腘绳肌腱移植进行重建应用较多,腱-骨愈合的时间较长,限制了患者交叉韧带重建后早期的功能活动.目的:用浓缩自体骨髓植于前交叉韧带重建腱-骨界面,观察其界面愈合情况.方法:32只新西兰大白兔行双侧膝关节半腱肌肌腱前交叉韧带重建,随机选取一侧膝关节作为实验组,胫骨侧腱骨界面植入自体浓缩骨髓,对侧不植入作为对照组.结果与结论:组织学显示,前交叉韧带重建后2周对照组移植肌腱与骨隧道的界面由肉芽组织填充,连接组织松散,有成骨活动;实验组移植肌腱与骨隧道界面肉芽组织连接亦不紧密,骨隧道侧成骨活动较活跃.前交叉韧带重建后12周对照组腱骨结合部组织界面变模糊,可见胶原纤维-纤维软骨-钙化的软骨组织-骨组织的移行带改变;实验组显示明显的胶原纤维-纤维软骨-钙化的软骨组织-骨组织的移行带改变,潮线清晰.前交叉韧带重建后4,8,12周,实验组最大抗拉脱强度数值显著大于对照组(P<0.05).提示自体浓缩骨髓可以增强腱骨界面的抗拉伸强度,有利于腱-骨界的组织愈合.
배경:전교차인대단렬후응용자체객승기건이식진행중건응용교다,건-골유합적시간교장,한제료환자교차인대중건후조기적공능활동.목적:용농축자체골수식우전교차인대중건건-골계면,관찰기계면유합정황.방법:32지신서란대백토행쌍측슬관절반건기기건전교차인대중건,수궤선취일측슬관절작위실험조,경골측건골계면식입자체농축골수,대측불식입작위대조조.결과여결론:조직학현시,전교차인대중건후2주대조조이식기건여골수도적계면유육아조직전충,련접조직송산,유성골활동;실험조이식기건여골수도계면육아조직련접역불긴밀,골수도측성골활동교활약.전교차인대중건후12주대조조건골결합부조직계면변모호,가견효원섬유-섬유연골-개화적연골조직-골조직적이행대개변;실험조현시명현적효원섬유-섬유연골-개화적연골조직-골조직적이행대개변,조선청석.전교차인대중건후4,8,12주,실험조최대항랍탈강도수치현저대우대조조(P<0.05).제시자체농축골수가이증강건골계면적항랍신강도,유리우건-골계적조직유합.
BACKGROUND:There are a lot of applications of hamstring tendons autografts in the reconstruction of anterior cruciate ligament, which needs a long term for the tendon-bone healing and restricts the early functional activities of patients. OBJECTIVE:To evaluate the effect of condensed autologous bone marrow transplantation on the tendon-bone interface in the reconstruction of anterior cruciate ligament. METHODS:One knee joint was chosen as the experimental group and the other side as the control group in 32 New Zealand rabbits experiencing the reconstruction of anterior cruciate liagment. The tibial tendon-bone interface was injected with condensed autologous bone marrow in the experimental side and the other side was not injected as the control. RESULTS AND CONCLUSION:The histological anatomy showed the tendon-bone interface was fil ed with granulation tissues that were loose, and there were some activities of bone formation in the control group at 2 weeks after operation;the tendon-bone interface was fil ed with granulation tissues that were not compact, but there were active activities of bone formation in the experimental group at 2 weeks after operations. The bound between the tendon and bone was becoming obscure, and there were col agen fiber-fibrocartilage-calcified fibrocartilage-bone transitional zones at the interface in the control group at 12 weeks after operation. In the experimental group, there were conspicuous col agen fiber-fibrocartilage-calcified fibrocartilage-bone transitional zones and clear tidal line at the interface. The maximal pul-out loads in the experimental group were higher than those in the control group at 4, 8 and 12 weeks after operation (P<0.05). These findings indicate that condensed autologous bone marrow transplantation can enhance the tensile strength of tendon-bone interface, and can do good to tendon-bone healing in a bone tunnel.