摘要
目的探讨改善前交叉韧带重建后早期移植腱隧道界面愈合方式。方法取成年新西兰兔同侧半腱肌肌腱作为自体移植材料,建立30只新西兰兔双侧前交叉韧带重建动物模型。实验组在移植腱-骨隧道界面注射填充以纤维蛋白胶作为载体的rhBMP-2,对照组仅填充纤维蛋白胶,完全空白对照组则不作任何填充。分别于术后第2、4和8周取材,进行大体及光镜观察。结果对照组术后2周界面组织主要为肉芽组织,术后4周界面可见成骨反应及大量成纤维细胞,术后8周界面部分区域可见Sharpey纤维,形成间接止点。实验组术后2周界面组织主要由软骨细胞和软骨基质构成,术后4周可见类似直接止点的四层结构,术后8周界面主要由直接止点构成。结论rhBMP-2可以在术后早期诱导腱骨界面形成类似直接止点的特有结构,直接止点缓冲应力的力学性能上要优于间接止点,增强了腱骨界面的结合力。
Objective To observe the effect of recombinant human bone morphogenetic protein-2 （rhBMP-2） in promoting the tendon-bone healing in rabbits after anterior cruciate ligament reconstruction. Methods Thirty normal adult New Zealand rabbits were divided into 3 groups for anterior cruciate ligament reconstruction using autologous semitendinosus tendons as the graft material. In the rhBMP-2 group, fibrin glue （FG） containing rhBMP-2 was applied to the interface between the tendon graft and the bone tunnel, while in the FG control group, only FG was applied. The blank control group received no treatment after the surgery. The grafts were collected at 2, 4, 8 weeks after the surgery for gross observation and histological examination of the graft incorporation. Results In the FG control group, the tendon-bone interface was filled with granulation tissue 2 weeks after the surgery, and the newly generated tissue growing into the bone tunnel and fibroblasts were observed at 4 weeks. Till week 8, Sharpey＇s fibers were found in the interface with the formation of indirect insertion. In the rhBMP-2 group, the tendon-bone interface was filled with cartilage tissue at 2 weeks, and the four-layer direct insertion was formed at 4 weeks; till week 8, the interface was mainly composed of the direct insertion. Condusion rhBMP-2 can induce direct insertion formation in the tendon-bone interface after early anterior cruciate ligament reconstruction. The direct insertion possesses better biomechanical properties than indirect insertion.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2008年第10期1869-1873,共5页
Journal of Southern Medical University
关键词
重建前交叉韧带
骨形态发生蛋白
腱骨愈合
anterior cruciate ligament reconstruction
bone morphogenetic protein
tendon-bone healing
