摘要
目的探讨转化生长因子β1(transforming growth factorβ1,TGF-β1)和碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)对自体腘绳肌腱重建前交叉韧带(anterior cruciate ligament,ACL)后腱-骨愈合的影响。方法2018年1—12月选取健康雄性新西兰大白兔48只,体重2.5~3.0 kg,按照随机数字法分成2组,每组24只,2组均采用自体腘绳肌腱重建ACL,A组(实验组):骨隧道的腱骨间隙填注入TGF-β1和b FGF纤维蛋白凝胶复合物;B组(对照组):骨隧道腱骨间隙填注入纤维蛋白凝胶,术后4、8、12周不同观察节点猝死动物观察2组移植ACL的组织学形态、生物力学性能,分析并比较。结果组织学方面:术后4周,2组移植韧带与骨隧道之间可见疏松结缔组织,胶原纤维开始形成,A组多于B组;术后8周,A组可见移植韧带与骨隧道之间胶原纤维已经开始排列有序,并出现排列密集的Sharpey纤维,B组Sharpey纤维较少;术后12周,A组韧带止点结构排列较有序,新生纤维软骨、钙化软骨及骨细胞趋于成熟,隐约可见到"潮线"样结构,B组结构仍然不清晰。在术后每个观察节点,A组的新生骨量在逐渐增多,并且在同一观察节点要大于B组,差异有统计学意义(均P<0.05);力学方面:术后4周A、B组最大抗拉力载荷分别为(72.69±5.09)N、(61.59±5.82)N,8周(83.00±5.24)N、(73.93±8.89)N,12周(102.39±6.42)N、(85.12±9.59)N,2组力学均有提高,A组平均抗拉力载荷均明显大于B组(均P<0.05)。结论TGF-β1、bFGF复合物对自体腘绳肌腱重建ACL后腱-骨愈合在一定程度上起到促进作用。
Objective To investigate the effect of TGF-β1 and bFGF on tendon-to-bone healing after anterior cruciate ligament(ACL)reconstruction with hamstring tendon autograft.Methods A total of 48 healthy male New Zealand white rabbits,body weight 2.5-3.0 kg,were selected between January 2018 and December 2018 and divided into two groups in accordance with the random number table,with 24 in each group.ACL reconstruction with hamstring tendon autograft was performed in both groups.In group A,TGF-β1 and bFGF fibrin gel complexes were filled in the tendon-bone gap of the posterior hamstring tendon tunnel after transplantation;in group B,fibrin gel complexes were filled in the tendon-bone space of bone tunnel.The histological morphology and biomechanical properties of ACL transplanted in the two groups were observed at 4,8 and 12 weeks after the operation,and the results were analyzed and compared.Results The results of histological examination:At 4 weeks after the operation,loose connective tissue was observed between the transplanted ligament and bone tunnel in both groups,and the collagen fibers began to form,which was more in group A as compared with group B.On W8 after the operation,the collagen fibers between the transplanted ligament and bone tunnel in the group A began to arrange in an orderly manner,and there were dense Sharpey fibers in the group B.On W12 after the operation,the ligaments in the group A began to arrange in an orderly manner.The structure of the endpoints was arranged orderly,the new fibrocartilage,calcified cartilage and osteocytes tended to mature,and the"tidal line"structure was seen dimly.The structure of the group B was still unclear.At each observation node after the operation,the new bone mass of the group A increased gradually,and at the same observation node was larger than that of the group B(all P<0.05).In mechanics,the results of ultimate tensile strength in groups A,and B were(72.69±5.09)N,(61.59±5.82)N respectively at 4 weeks,(83.00±5.24)N,(73.93±8.89)N respectively at 8 week,(102.39±6.42)N,(85.12±9.59)N respectively at 12 weeks,the load of the group A was significantly higher than that of the group B at each observation node,and the difference between the two groups was significant(all P<0.05).Conclusion TGF-β1 and bFGF can promote tendon-bone healing after ACL reconstruction with hamstring tendon autograft.
作者
张培
刘泉
吴敏
周建生
谢兴
潘功平
ZHANG Pei;LIU Quan;WU Min;ZHOU Jian-sheng;XIE Xing;PAN Gong-ping(Department of Orthopaedics,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)
出处
《中华全科医学》
2020年第1期30-33,共4页
Chinese Journal of General Practice
基金
安徽省高校省级自然科学研究重点项目(KJ2016A870)
蚌埠医学院科技发展基金项目(BYKF1765).
关键词
前交叉韧带
重建
生长因子
腱骨愈合
Anterior cruciate ligament
Reconstruction
Growth factors
Tendon-to-bone healing
作者简介
通信作者:刘泉,E-mail:13955230608@163.com
