兔膝内侧副韧带修复及内侧半月板切除对膝骨关节病发病过程的影响

通过经典的建立膝骨关节病运动模型的方式，设计了在切除内侧半月板的情况下，将内侧副韧带（ＭＣＬ）切断和切断后再缝合恢复张力的两组动物模型。观察术后５、１０、１５、２０天，关节软骨的组织学、组织化学及扫描电镜下形态学方面的变化，旨在探讨切除内恻半月板时，恢复ＭＣＬ的张力对膝骨关节病（ＯＡ）发病过程的影响。实验结果显示，ＭＣＬ切断无张力组和ＭＣＬ缝合有张力组于术后５天，在光镜下，关节软骨即出现某此变化。包括敕骨细胞排列紊乱，增生层有软骨细胞簇集现象、族集细胞的周围甲苯胺兰深染。增生层和肥大层一些软骨陷窝有细胞消失现象，其周围淡染。术后５、１０天扫描电镜观察，两实验组关节软骨表面未见异常改变。术后１５、２０天，光镜下，两实验组关节软骨退行性改变进一步加重，扫描电镜观察，两实验组软骨表面正常结构消失、胶原纤维断裂，软骨显微骨折、出现部分软骨细胞裸露及细胞消失现象。韧带无张力组及有张力组，在软骨退行性变化方面未见明显程度上的差别，结果表明，只要兔半月板切除，无论ＭＣＬ张力存在与否，都不能阻止ＯＡ的产生，亦不能减轻其发生的程度。

The Influence of Repair of Knee Medial Collateral ligament(MCL)and Medical Meniscectomyon Pathogenesis Process of Osteoarthritis(OA)in Rabbits

Abstract Two groups of rabbits were operated for the purpose of observing the influence of repair of knee MCL and medial meniscectomy on the pathogenesis process of OA.Both groups accepted medial meniscectomy and in one group,MCL were severed and re-sutured for restoration of tension;in another,as the classical model for OA in rabbits,MCL were excised.After 5,10,15 and 20 days of oper- ation,articular cartilage,synovium and medical capsule including MCL were harvested for examination histo-and histochemically,carti- lage specimens were also processed for scanning electron microscopical(SEM)exam.Results showed that as early as f5 days after op- eration,some changes have already existed in cartilage,including disorder of chondrocytes arrangement;cell clusters around with strong staining by tuiluding blue in proliferation zone;local destaining area with cell disappearance in some lacunae in proliferation and hypertrophic zone,However,SEM remained unchanged on the surface of cartilage in 5 and 10 days after operation .15-20 days after operation,microscopic specimens showed typical OA changes including chondrocytes death with empty lacunae;cell clusters around with strong positive staning by tuiluding blue;enlarged destaining area proliferated synovial cells;disarranged and degenerated collagen fibres,SEM showed destroy of cartilage surface,rupture of collagen fibres,micro fracture of cartilage from surface down to deep zone with empty lacunae.There were no difference between two groups.Our results suggested,once the medial meniscus re- moved,no matter how the tension existed due to MCL,development of OA is inevitable.The tension from medial side might not help to prevent the pathogenesis process of OA,nor decrease the extent of severity.