| Objective:The damage of anterior cruciat ligament(ACL) is one of commonly and frequently encountered diseases on clinical.It is a ideal method to apply allograft tendon ACL of cryopreservation in arthroscope and this method has acquired well effect.It not only corresponds to micro-operation,but also avoids the syndrome of autoallergic materials.However,there is no report about how the rejection of receptor to the transplants and transplantation immunology research combined with clinical cases.The study summarizes 30 examples of arthroscopic ACL reconstruction with allogenic tendon, retrospectively analyzes the clinical characters of oesteopontin (OPN),T-cell subpopulations,ESR,CRP, white blood cell count, pain of knee and hydrops in knee,and compares with 23 cases of autogenic tendon reconstruction in the corresponding time period.The aim is to observe and approach the character of early immune rejection after allogenic tendon reconstruction ACL.Methods:The 53 patients of ACL damage were selected in the third hospital of Hebei province from March 2009 to January 2010.30 examples were applied arthroscopic for ACL reconstruction with autogenic tendon,17 cases of the total are male and 13 cases are female.The age arranges from 17 to 46 years old,and the equal age is 26.9±9.0 years old.The leftside damaged has 19 cases,and rightside damaged has 11 cases.11 patients have meniscus injury,and 13 patients have I degree cartilage injury.23 examples with ACL injury were applied arthroscopic autograft Hamstring tendon as comparison.14 cases are male and 9cases are female.The age arranges from 17 to 43 years old,and the equal age is 25.3±7. 8 years old. The leftside damaged has 13 cases,and rightside damaged has 10 cases.9 patients have meniscus injury,and 6 patients have I degree cartilage injury.All patients of the two groups are with single knee athletic injury.All of the sternums of these patients are nomal.The acute traumatism cases whose evaluation index before operation is above the normal level are precluded.After the operation,all the cases are usd of antibiotics routinely.All the patients in the two groups are gathergd peripheral blood in the preoperative and first day, fourth day and eleventh day after the operation.We detect OPN through enzyme linked immunosorbent assay, T lymph cell subgroup through flow cytometry, erythrocyte sedimentation rate through Westergron, and C reactive protein through scattering nephelometry.We closely observe the status of total body and damaged knee of the patients in different stages of the preoperative and postoperative(including the white blood cell count,wound reaction,juice in arthrosis and motion of joint).Results: The wounds of the autogenic tendon group cured well.One case of allogenic tendon group occurred postoperative infection at the tibia tunnel.After the cut debridement,douching repeatedly,saturation,and anti-infective therapy,the symptom disappeared.One patient occurred interruptive fever which lasted half month and joint swelling after operation.The symptom disappeared completely after joint puncture and injecting 5mg hexadecadrol.There was no significant difference of the mean density of OPN of different times between preoperation and postoperation.However, all the OPN allogenic tendon reconstruction groups,densities of different times of were higher than that of autogenic tendon reconstruction group. All the highest value occured in the first day after operation,and falls off afterward.There was no significant oesteopontin density difference in the statistics between the two group.All the ratios of CD3+T, CD3+TCD4+T,CD4+/CD8+ decreased.All the lowest values occured in the first day after operation,and advanced gradually. CD3+TCD8+T showed descending progressingly. There is no statistics difference of T lymph cell subgroup in the preoperation or in the first,fourth,and eleventh day after operation. All the allogenic tendon reconstruction group's erythrocyte sedimentation densities at different times after operation were higher than autogenic tendon reconstruction group's.The highest value of the two groups occurred in the fourth day after operation,and decreased gradually afterwards. All the allogenic tendon reconstruction group's CRP densities at different times after operation were higher than autogenic tendon reconstruction groups. The highest value of the two groups occurred in the first day after operation,and decreased gradually afterwards.There were no statistic differences with the mean ESR density and CRP density of defferent times before or after operation. Compared to the autogenic tendon reconstruction group,the differences of the pain of knee, the pain and juice in joint,and the ratio of white blood cell increasing of the allogenic tendon reconstruction group were not statistically significant,but showed the higher tendency than autogenic tendon reconstruction group in total.Conclusions : There was no statistic differences in the groups of arthroscopic ACL reconstruction with allogenic and autogenic tendon about the early immune rejection after operation.The incidence rate of adverse reaction of the group of allogenic tendon is low. But all the indexes of the allogenic tendon group were higher than those of the autogenic tendon group.It indicates that there is slender immunologic rejection in the early ACL reconstruction with allogenic tendon。... |
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