富血小板血浆复合物对前交叉韧带重建术后影响的影像学观察

目的前交叉韧带（anterior cruciate ligament,ACL）重建成功的关键是移植肌腱与骨隧道之间的牢固愈合,从而恢复韧带的功能。本实验通过影像学观察评价富血小板血浆（platelet rich plasma,PRP）复合小牛脱蛋白松质骨（deproteined bone,DPB）对ACL重建术后腱-骨愈合的影响,为临床应用提供实验依据。方法将36只新西兰大白兔随机分为四组,即PRP＋DPB组（实验组）9只、PRP组（对照组1）9只、DPB组（对照组2）9只、单纯重建组（空白组）9只,每只兔均取自体单股半腱肌移植重建双膝ACL。实验组在骨隧道中填塞PRP＋DPB复合物,对照组1在骨隧道中填塞PRP,对照组2在骨隧道中填塞DPB,空白组不填塞任何材料,分别于术后4、8、12周取材行大体观察及Micro-CT扫描,测量腱-骨结合部新生骨组织的骨密度值（mg/cm3）及骨隧道关节侧入口处的直径大小,观察对比腱-骨愈合情况以及骨隧道扩大情况。结果在ACL重建后的各个时间点上,实验组腱-骨结合部新生骨组织的骨密度值均高于对照组1、2和空白组,其差异具有统计学意义;对照组1腱-骨结合部新生骨组织的骨密度值高于对照组2及空白组,但其差异无统计学意义;对照组2腱-骨结合部新生骨组织的骨密度值与空白组相比无显著性差异。实验组的骨隧道扩大程度小于对照组1、2和空白组,其差异具有统计学意义;对照组1的骨隧道扩大程度小于对照组2及空白组,但其差异无统计学意义;对照组2的骨隧道扩大程度与空白组相比无显著性差异。结论富血小板血浆复合物可显著提高兔ACL重建术后腱-骨界面的骨密度,预防骨隧道的扩大。

The Study of Imaging Findings on the Effect of Reconstructed Aanterior Cruciate Ligament with PRP Compound

Objective To evaluate the effects of platelet rich plasma(PRP)combined with DPB(deproteined bone) on tendon-bone healing after ACL reconstruction,and to provide experimental evidence for clinical application.Methods Thirty-six healthy New Zealand rabbits were randomized into 4 groups to be on reconstruction+PRP(experimental group,n=9),or reconstruction+PRP(control group1,n=9),or reconstruction+DPB(control group2,n=9),or a simple group of usual reconstruction(blank group,n=9).The experimental group were filled with PRP+DPB compound in the bone tunnel,control group1were filled with PRP,control group2 were filled with DPB,and while the blank group did not received any stuffing.Samples received general sample observation,CT scanning,BMD of new born bone round the combining site of tendonbone and the diameter of bone tunnel at weeks 4,8 and 12 after operation,so as to observe the healing of tendon-bone and enlargement of bone tunnel.Results The BMDs in experimental group were significant higher than the other group at all time points(P<0.05).But the BMDs in the control group 2 and blank group had no significant differences compared with control group1(P>0.05).And the comparison of BMDS between control group2 and blank group had the same result.The enlargement of tunnel in the experimental group was significantly higher than that in the control group1,control group2 and blank group(P<0.01).There were no significant differences in enlargement between control group1,control group2 and blank group(P>0.05);and the comparison between the control group 2 and blank group had the same result.Conclusion PRP compound can increase BMD of tendon-bone interface while preventing the enlargement of tunnel following ACL reconstruction.