摘要
[目的]观察复合有富血小板血浆(platlet rich plasma,PRP)明胶海绵复合物的自体肌腱移植物对前交叉韧带重建术后骨隧道与肌腱间愈合过程的影响,探讨其在腱与骨愈合中发挥的效果。[方法]新西兰大白兔36只,无菌条件下获取自体PRP,制备PRP明胶海绵复合物,左下肢行自体跟腱移植前交叉韧带重建术。A组(实验组)使用PRP明胶海绵复合物;B组(对照组1)使用PRP;C组(对照组2)仅为肌腱。植入2、4、8、12周后,制作标本,进行大体及HE、Masson染色和TGF-β1免疫组化观察。[结果]A组标本大体观察:前交叉韧带连续性及张力良好,术后2周骨隧道口见少量瘢痕组织;4周骨道口见小部分骨样组织,8周骨道口较多瘢痕呈现,12周骨道口现较多骨样成分。组织学观察:HE染色显示,A组出现Sharpey样纤维和软骨细胞明显早于B组和C组;同样在Masson结果中,A组出现有规则的胶原纤维也明显多于B组和C组。TGF-β1免疫组织化学观察:2、4、8周,A组阳性率明显高于B、C组,差异具有统计学意义(P<0.05)。而在术后12周时,各组之间的表达无明显差异(P>0.05)。[结论]PRP明胶海绵复合物可促进前交叉韧带重建后腱骨的早期愈合。
[Objective] To explore the effect of complex of platelet rich plasma （PRP） and gelfoam on tendon-bone healing in anterior cruciate ligament （ACL） reconstruction. [Methods] Thirty-six New Zealand white rabbits, without any histological defect, were utilized and divided into three groups randomly. Autologous PRP was obtained in sterile environ- ment, and the complex of PRP and gelfoam was prepared. Autograft of Achilles tendon was used to reconstruct ACL at the left knee in all of the three groups. In the group A the complex of PRP and gelfoam was used, in the group B only PRP was applied, while in the group C nothing was added round the tendon graft. Specimens were harvested at 2, 4, 8, 12 weeks after opera- tion for gross observation and histological investigation including hematoxylin eosin staining, modified trichrome staining and immunohistochemistry staining of TGF-β1 as well. [Results] In group A, gross observation revealed that the reconstructed ACL had good continuity and tension. New osseous tissue round the tunnel increased over time. On the histological observation HE staining showed that Sharpey type fiber and chondrocyte-like cells appeared earlier in the group A than in the group B and group C obviously. Similarly, regular fiber in the group A was significantly in more density than the other two groups shown by Masson staining. Immunohistochemistry demonstrated that continually higher expression of TGF-β1 had been observed in the group A compared to the other two groups from 2 weeks to 8 weeks with significant difference （P〈0.05）, whereas at 12 weeks,no continued significant differences among the three groups were noted （P〉0.05） . [Conelusionl Application of the complex of PRP and gelfoam do promote the tendon- bone healing at early stage after ACL reconstruction.
作者
张明宇
张宪
杨镇
郑江
张亮
ZHANG Ming-yu ZHANG Xian YANG Zhen et al(Department of Sports Medicine, Honghui Hospital of Medical College of Xi ＇an Jiaotong University, Xi ＇an 710054, China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第8期737-742,共6页
Orthopedic Journal of China
基金
陕西省自然科学基金项目(编号:2016JM8138)
陕西省卫计委科研基金项目(编号:2014D51)
关键词
富血小板血浆
明胶海绵
前交叉韧带重建
腱骨愈合
platelet-rich plasma, gelfoam, ante- rior cruciate ligament, tendon-bone healing
