前交叉韧带断裂和重建对膝关节软骨退变影响的实验研究

目的：研究前交叉韧带（ACL）断裂和不同时期重建对膝关节软骨继发损伤的影响。方法：以新西兰大白兔为实验对象,共14只。共分4组,每组7个膝关节,实验组Ⅰ：右膝前交叉韧带切断后随即重建,左膝的前交叉韧带切断后不予重建作为对照组Ⅰ;组Ⅱ：右膝前交叉韧带切断后3周重建,左膝行单纯关节切开术作为对照组Ⅱ。术后8周通过墨汁染色,常规组织学及扫描电镜方法观察各组膝关节软骨退变的情况。结果：（1）实验组Ⅰ关节软骨退变程度明显轻于对照组Ⅰ（Hc=5.9889,P=0.0144);(2)实验组Ⅱ关节软骨退变程度和对照组Ⅰ相比差异无显著性意义（Hc=0.7143,P=0.785)。结论：（1）ACL断裂后即刻重建可以有效阻止关节软骨继发损伤的发生;（2）ACL断裂后已继发关节软骨退变时再行重建,其对关节软骨退行性变的缓解作用不明显。ACL 裂后应进行早期重建,恢复膝关节稳定性,减少或延缓远期骨性关节炎的发性。

The effect of anterior cruciate ligament rupture and reconstruction on the degeneration of articular cartilage in rabbit knee

OBJECTIVE: To investigate the effect of rupture and reconstruction of the anterior cruciate ligament (ACL) on the degeneration of rabbit knee articular cartilage. METHODS: 14 mature New Zealand white rabbits were divided into four groups. In group I, the ACL of the right knees in 7 rabbits was resected and immediately reconstructed, and the contralateral ACL was resected only in controll f group I. In group II, the ACL of the right knees in 7 rabbits was reconstructed 3 weeks after the ACL was resected and the contralateral joints in control group II, in which only a medial arthrotomy was performed. The rabbits were killed 8 weeks after the operation. The methods of ink straining, histology and SEM were used to analyze the changes in articular cartilage of the joints. RESULTS: The results of ink method and HE straining were analyzed quantitatively. The degeneration of knee articular cartilage in group I was significantly weaker than that in control group I (Hc = 5.9889, P = 0.0144). The degeneration of knee articular cartilage in group II was as serious as that in control group I (Hc = 0.7143, P = 0.785). CONCLUSIONS: Immediate reconstruction of the ACL can effectively prevent articular cartilage from degeneration. Once the articular cartilage damaged moderately, delayed reconstruction of the ACL could not effectively reduce the development of degeneration. So once the ACL is ruptured, reconstruction should be performed in the early stage to restore the stability of knee joint to prevent the articular cartilage from degeneration.