自体半腱肌腱重建兔前交叉韧带腱骨愈合和止点形成实验研究

目的:观察应用自体半腱肌腱重建兔前交叉韧带术后12个月内腱骨愈合的组织学变化过程。方法:取新西兰大白兔同侧自体单股半腱肌腱重建前交叉韧带,分别于术后2周,1、2、4、6、12个月取材,采用HE和甲苯胺蓝染色观察骨道内腱骨间愈合和止点形成的组织学变化过程。结果:术后2周,腱组织坏死,腱骨间形成肉芽组织界面,其中的新生组织细胞向坏死腱内长入、替代,术后1个月腱骨间形成Sharpey纤维连接和纤维软骨,术后4个月形成潮线样结构,6个月形成直接止点的四层结构,12个月更加成熟。结论:前交叉韧带重建后腱骨间的愈合是一个由间接止点转化为直接止点的骨源性渐进过程。

Experimental Study on Tendon-bone Healing and Insertion Formation in Anterior Cruciate Ligament Reconstruction Using Semitendinosus Tendon Autograft in a Rabbit Model

Objective To observe the histological change in the tendon-bone healing and insertion formation in anterior cruciate ligament(ACL) reconstruction with semitendinosus tendon autograft over 12 months after surgery. Methods We performed an ACL reconstruction in a rabbit model using a single ipsilateral semitendinosus tendon autograft. Specimens of the grafts were collected at 2 weeks and 1, 2, 4, 6, 12 months after surgery. Histological change in the tendon-bone healing was studied by haematoxylin-eosin and toluidine blue.Results Tendon necrosis was evident 2 weeks after surgery.The interface between tendon and bone was filled with granulation tissue. The new born tissue grew into the graft from the granulation tissue.Sharpey’s fibers and fibrocartilage appeared in the interface 1 month after surgery. A tidemark could be seen 4 months after surgery. A direct insertion was formed 6 months after surgery, and became more mature 12 months after surgery. Conclusion Tendon-bone healing after ACL reconstruction originates from the bone; an indirect insertion gradually becomes a direct one.