| Objective：Anterior cruciate ligament rupture is a common sports injury, onlybe a substitute for reconstruction after fracture to restore stability and functionof the knee. Currently used clinically ligament substitutes mainly autologousligament allograft ligament grafts and artificial materials. Reconstruction ofthe three types of materials, there are many drawbacks, not the ideal choiceon clinically. Since no secondary damage for the area, as well as preservation,drawing improvements in technology, currently tendon allograft achievedwidespread application in clinical. Implanted tendon allograft, autologoustendon healing process is similar, all need four stages of undergoes necrosis,vascularization, cell creeping substitution, remodeling. The test was preparedby the same species of allogeneic bone patellar tendon bone graft andsemitendinosus as a test material.We used bone tendon bone andsemitendinosus of experimental animals to reconstruction of the anteriorcruciate ligament in experimental animals,for researching the advantagesand disadvantages of anterior cruciate ligament reconstruction by grossobservation, histological and biomechanical three ways.Methods： Experimental group, bone tendon bone as reconstruction materialand the control group of animals autologous semitendinosus or gracilis asreconstruction materials,for the establishment of36adult New Zealand whiterabbits animal model of unilateral anterior cruciate ligament reconstruction.Experimental group maked single bone tendon bone to double bone tendonbone,the control group take complete long enough semitendinosus and gracilisto pretension and not do special treatment. ACL reconstruction simulate theclinical and the ligament ends of the bone tunnel fixation method are all usedosteopontin.We doing general observation, histological and biomechanical examination after4,8,16weeks respectively. Animals were observed aftereating, activity, wound healing, postoperative1-2weeks to observe localredness, swelling around the incision, exudate and other symptoms ofinfection, animals were observed gait and joint activities. Histologicalobservation:4,8,16weeks after surgery, in each group were euthanized fourrabbits randomly with urethane intravenous treatment respectively,whichremove four right knee as histological specimens, four left knee forbiomechanical testing specimens. Biomechanical examination: Two subjectswere drawn at4weeks,8weeks,16weeks and every four rabbits weresacrificed in each group. Cut joints of animals, each retain the distal femurand proximal tibia3cm, remove soft tissue, removal of the meniscus and theposterior cruciate ligament,only retaining the anterior cruciate ligament ofreconstruction, specimens saline, saline dressing wrapped in plastic placed insealed bags-80°cryogenic refrigerator, centralized biomechanical testingafter14d.Result：General observation:There were1,2knee incision appears red andswollen, pus, in the experimental and control groups, the control group had aknee animals without signs of infection, but the performance of lower limbdeformities, was subluxation state, subsequent CT confirmed knee dislocation.This three animals removed in accordance with the experimental designrequirements, subsequent supplementary three included trials, and theremaining animals recovered well after surgery, the incision is no swelling, noabnormal knee motion feature, enter test data analysis. Histologicalexamination: The control group, the interface can be seen full of a lot of looseconnective tissue, a small amount of inflammatory cell infiltrationperformance after four weeks, the interface seen dense fibrous tissueclosely connected with ligaments after8weeks, new bone formation, theinterface is visible Sharpey fibers after16week. No significant calcification offibrocartilage. Experimental group after four weeks, the interface is filled witha lot of dense connective tissue, inflammatory cell infiltration, new boneformation, part of the interface region is visible Sharpey fiber structure after eight weeks, ligament-bone interface was Sharpey fiber structure in the main,calcification of fibrocartilage after16weeks. Biomechanical examination:Biomechanical comparison of bone-tendon-bone grafts and four foreignstocks semitendinosus graft Conclusion：Double bone tendon bone allograft, four stranded semitendinosusgraft in anterior cruciate ligament reconstruction surgery can effectivelyfunction before resuming cruciate ligament. Allogeneic bone tendon bonegraft layer in the reconstruction of the anterior cruciate ligament of the kneecan provide a more robust initial strength and final strength, and have bettermatching tendon tunnels, so that the knee joint can get better stability andjoint function. |
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