人工韧带及骨界面结合实验探究.doc

人工韧带及骨界面结合实验探究 　作者：韩增斌，郭秀程，徐栋，王伟，刘庆鹏，陈光，贾庆卫 【摘要】 [目的]利用韧带先进加强系统(ligament advanced reinforcement system, LARS)重建实验动物的前交叉韧带(anterior cruciate ligament, ACL)，研究LARS人工韧带与骨界面结合的情况。[方法]取雄性成熟波尔山羊24只，随机分成3组。利用临床ACL重建系统建立动物实验模型。分别于术后4、8、12周取材做大体观察、组织学、影像学和生物力学检查。所得实验数据进行统计分析。[结果](1)术后4周组织学显示韧带-骨界面充满大量的疏松结缔组织，可见到炎细胞浸润表现;术后8周韧带-骨界面之间有新骨形成。部分标本出现Sharpey纤维结构;术后12周韧带-骨界面见大量的Sharpey纤维结构及大量的成纤维细胞。未见钙化软骨;(2)对第3组实验动物术后4、8、12周进行影像学检查，然后利用eflime图像处理软件所得数据进行统计学分析。结果显示有显著性统计学差异(Plt;0.01);(3)生物力学测试发现，在不同时间点均将韧带从骨隧道中拉出，韧带无一断裂。结果显示没有统计学差异(Pgt;0.05)。[结论]LARS人工韧带重建ACL后，其两端骨隧道中韧带-骨界面可通过Sharpey纤维结构，形成间接连接，促进韧带-骨的结合，增强韧带-骨愈合的强度。 【关键词】 LARS; 人工韧带; 骨界面; 结合 Experimental study on integration of artificial ligament with bone interface∥HAN Zengbin, GUO Xiucheng,XU Dong,et al. Department of Orthopedics,the Affiliated Hospital of Taishan Medical College, Shandong,Tai’an 271000, China 　　Abstract：[Objective]To reconstruct anterior cruciate ligament (ACL) by using ligament advanced reinforcement system(LARS),and to investigate the integration of LARS artificial ligament with bone interface in the animals with regard to imageology, biomechanics and histology.[Method]Twentyfour Boer goats were randomly divided into three groups. The animal mode of ACL reconstruction was established by clinical ACL reconstruction system. Gross observation was made, and histological, imageological and biomechanical changes were observed at 4, 8 and 12 weeks after surgery, respectively. Statistical analysis was performed.[Result](1)At 4 weeks after surgery,ligamentbone interface had great amount of loose bindweb and infiltration of chronic inflammation cells. At 8 weeks after surgery, there was new bone formation. Part of samples had Sharpey fibers. At 12 weeks after surgery, Sharpey fibers.and a large number of fibroblasts were noted in the interface between LARS artificial ligament and bone interface. But calcified cartilage was not founded.(2)The imageology examination for group 3 was made at 4, 8 and 12 weeks after sur