不同材料联合前交叉韧带和内侧副韧带置换:一项比较动物研究。

L Claes, L Dürselen, H Kiefer, W Mohr
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引用次数: 0

摘要

在30只羊身上,用四种不同的材料进行了右膝前交叉韧带和内侧副韧带的联合置换。采用涤纶假体和戊二醛保存的牛肌腱假体以及碳纤维和编织可吸收聚二恶酮纤维制成的编织韧带假体,关节内部分采用冻干硬脑膜包裹。10只未手术的羊作为对照组。1年后处死,移植膝关节,进行生物力学和组织形态学研究。关节的大体检查显示没有断裂的内侧副韧带置换,但确实显示部分和完全断裂的前交叉韧带置换。涤纶假体在50%的病例中断裂,而其他材料的假体各有一例韧带置换断裂(12.5%)。前抽屉试验和剩余韧带替代物的拉伸刚度测定显示,没有一个手术膝关节达到正常对照膝关节的特性。然而,碳纤维假体在所有测试的假体中效果最好。除可吸收聚二恶酮外,所有材料均可见前交叉韧带和滑膜内的磨损颗粒。对这些颗粒的组织反应是碳碎片的轻度滑膜炎,涤纶颗粒的强烈滑膜炎,对牛肌腱碎片的慢性炎症反应伴巨噬细胞肉芽肿和纤维化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The combined anterior cruciate and medial collateral ligament replacement by various materials: a comparative animal study.

On 30 sheep, a combined replacement of the anterior cruciate and medial collateral ligament of the right knee was performed with four different materials. Dacron prostheses and glutaraldehyde-preserved bovine tendon prostheses as well as braided ligament prostheses made of carbon fibers and braided resorbable polydioxanone fibers surrounded by lyophilized dura in their intra-articular part were used. Ten unoperated sheep served as a control group. After 1 year the animals were sacrificed and the knee joints were explanted and biomechanically as well as histomorphologically investigated. The gross inspection of the joints showed no ruptured medial collateral ligament replacement but did show partially and totally ruptured anterior cruciate ligament replacements. The Dacron prosthesis was broken in 50% of the cases, whereas for the other materials one ruptured ligament replacement each (12.5%) could be observed. The anterior drawer test and the determination of the tensile stiffness of the remaining ligament replacements revealed that none of the operated knees achieved the properties of the normal control knees. However, the carbon fiber implants had the best result of all prostheses tested. For all materials except the resorbable polydioxanone, abrasion particles could be found in the anterior cruciate ligament and in the synovial membrane. The tissue reaction to these particles was a mild synovitis for carbon fragments, a strong synovitis for Dacron particles, and a chronic inflammatory response to bovine tendon fragments with macrophage granulomas and fibrosis.

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