不同固定方式对腱-骨愈合界面影响的形态学研究

背景：关节镜下重建交叉韧带已得到广泛应用，关于腱骨愈合状态的研究多集中在患肢功能恢复以及愈合程度及稳定性观察方面。目的：了解韧带重建过程中各种固定方式对肌腱．骨界面愈合的影响。方法：2009年7月至2009年9月以长白二号体重100千克左右的八头成年猪的双膝关节作为实验对象进行动物实验，采用四种固定方式对腱-骨进行固定，包括纽扣接骨板悬吊固定、肌腱包裹自体松质骨方式、界面挤压螺钉固定、横穿可吸收钉固定，对手术后6周、12周时界面愈合的情况进行病理切片观察。结果：纽扣接骨板固定模式腱骨界面愈合均匀，理论抗拉力大，相反固定物对腱骨界面干扰明显的界面愈合不理想，骨纤维细胞排列不整齐，理论拉力降低，尤其表现在界面挤压螺钉方面；对于有自体松质骨植入的在腱骨愈合过程中活性骨质坏死，无促进腱骨愈合的作用。结论：在腱骨愈合过程中界面固定方式对早期愈合有不同程度的影响，悬吊固定方式腱．骨愈合界面形态学表现理想。

Effect of different fixations on tendon-bone healing interface:a morphological study

Background： The reconstruction of cruciate ligament under arthroscope has been widely applied. Nowadays, the study on tendon-bone healing is mostly focused on function recovery of patients and stability of healing. Objective： The purpose of the study is to explore the influence of different fixed styles to tendon-bone healing in the process of ligament reconstruction. Methods： From July 2009 to September 2009, eight adult Landrace II pigs weighing 100 kg was used as experiment animal and divided into four groups （n=2）. Four tendon-bone fixed methods were applied in both knee in each group respectively, including button-plate suspension fixation, autologous bone tendon wrapped mode, interface extrusion screw, and adsorb- able screw. The healing of interface was observed at 6 and 12 weeks postoperatively. Results： There was a large theoretical tensile strength for tendon-bone interface by button plate fixation. However, antolo- gous bone and screw interfered the healing of tendon-bone interface; fibrocytes were arranged irregularly and tensile strength was reduced, especially in the interface of extrusion screws. Conclusions： The fixation method of tendon can impact early bone healing. Tendon-bone healing by suspension fixation is better than other fixations in morphology.