目的?探討兔同種異體半月板移植后膝關(guān)節(jié)內(nèi)側(cè)間隙受力面積、壓強(qiáng)的變化及其生物力學(xué)重建情況。?方法?6～7月齡清潔級(jí)日本大耳白兔28只，雌雄不限，體重3.0～3.5 kg；隨機(jī)取7只兔右膝關(guān)節(jié)內(nèi)側(cè)半月板，制備同種異體半月板。余21只兔隨機(jī)分為3組，每組7只。A組為空白對(duì)照組，單純打開膝關(guān)節(jié)后縫合；B組為右膝內(nèi)側(cè)半月板切除組；C組為右膝內(nèi)側(cè)半月板切除后行同種異體半月板移植組。術(shù)后觀察各組實(shí)驗(yàn)動(dòng)物一般情況，于12周處死實(shí)驗(yàn)動(dòng)物取右膝關(guān)節(jié)行生物力學(xué)測(cè)試，并取A、C組半月板行組織學(xué)及免疫組織化學(xué)染色觀察。?結(jié)果?術(shù)后實(shí)驗(yàn)動(dòng)物均存活至實(shí)驗(yàn)完成。術(shù)后12周大體觀察見C組移植半月板愈合較好，前后角及體部附著良好。術(shù)后12周膝關(guān)節(jié)屈膝0、30、60、90°時(shí)，B組膝關(guān)節(jié)內(nèi)側(cè)間隙受力面積及壓強(qiáng)與A、C組比較，差異均有統(tǒng)計(jì)學(xué)意義（P lt; 0.05），A、C組間比較差異均無統(tǒng)計(jì)學(xué)意義（P gt; 0.05）；屈膝120°時(shí)，任意兩組間受力面積及壓強(qiáng)比較，差異均有統(tǒng)計(jì)學(xué)意義（P lt; 0.05）。組織學(xué)觀察顯示C組軟骨細(xì)胞及膠原纖維數(shù)量恢復(fù)正常；免疫組織化學(xué)染色示C組移植半月板內(nèi)膠原纖維含有大量Ⅰ型膠原和Ⅱ型膠原。術(shù)后12周A、C組Ⅰ型膠原含量分別為0.612 5 ± 0.059 8和0.587 2 ± 0.063 9，差異無統(tǒng)計(jì)學(xué)意義（t=0.765，P=0.465）；Ⅱ型膠原含量分別為0.772 4 ± 0.081 5和0.814 3 ± 0.051 7，差異無統(tǒng)計(jì)學(xué)意義（t= —0.136，P=0.894）。?結(jié) 論?兔同種異體半月板移植可增加膝關(guān)節(jié)受力面積，減小壓強(qiáng)，有利于保護(hù)關(guān)節(jié)軟骨，并可重建生物力學(xué)平衡。
引用本文： 薛超,羅殿中,衷鴻賓,張軼超,章亞東,侯樹勛. 兔同種異體半月板移植后膝脛股關(guān)節(jié)面生物力學(xué)重建的研究. 中國修復(fù)重建外科雜志, 2011, 25(4): 397-401. doi: 復(fù)制
| 1. | Stone KR, Adelson WS, Pelsis JR, et al. Long-term survival of concurrent meniscus allograft transplantation and repair of the articular cartilage: a prospective two- to 12-year follow upreport. J Bone Joint Surg (Br), 2010, 92(7): 941-948. |
| 2. | Harris JD, Cavo M, Brophy R, et al. Biological knee reconstruction: a systematic review of combined meniscal allograft transplantation and cartilage repair or restoration. Arthroscopy, 2010. [Epub ahead of print]. |
| 3. | 朱加亮, 衷鴻賓, 侯樹勛, 等. 異體半月板庫的建立及臨床初步應(yīng)用. 中國矯形外科雜志, 2007, 15(19): 1445-1447. |
| 4. | Lewis PB, Williams JM. Multiple freeze-thaw cycled meniscal allograft tissue: A biomechanical, biochemical, and histologic analysis. J Orthop Res, 2008, 26(1): 49-55. |
| 5. | Gelber PE, Gonzalez G, Torres R, et al. Cryopreservation does not alter the ultrastructure of the meniscus. Knee Surg Sports Traumatol Arthrosc, 2009, 17(6): 639-644. |
| 6. | 康曉琦, 章亞東, 衷鴻賓, 等. 異體半月板移植的實(shí)驗(yàn)研究和臨床應(yīng)用. 實(shí)用骨科雜志, 2008, 14(1): 37-39. |
| 7. | Flanigan DC, Lin F, Koh J, et al. Articular contact pressures of meniscal repair techniques at various knee flexion angles. Orthopedics, 2010, 33(7): 475. |
| 8. | Paletta GA Jr, Manning T, Snell E, et al. The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee. A biomechanical study. Am J Sports Med, 1997, 25(5): 692-698. |
| 9. | Lee DH, Kim SB, Kim TH, et al. Midterm outcomes after meniscal allograft transplantation: comparison of cases with extrusion versus without extrusion. Am J Sports Med, 2010, 38(2): 247-254. |
| 10. | van der Wal RJ, Thomassen BJ, van Arkel ER. Long-term clinical outcome of open meniscal allograft transplantation. Am J Sports Med, 2009, 37(11): 2134-2139. |
| 11. | Gomoll AH, Kang RW, Chen AL, et al. Triad of cartilage restoration for unicompartmental arthritis treatment in young patients: meniscus allograft transplantation, cartilage repair and osteotomy. J Knee Surg, 2009, 22(2): 137-141. |
| 12. | Vundelinckx B, Bellemans J, Vanlauwe J. Arthroscopically assisted meniscal allograft transplantation in the knee: a medium-term subjective, clinical, and radiographical outcome evaluation. Am J Sports Med, 2010, 38(11): 2240-2247. |
| 13. | LaPrade RF, Wills NJ, Spiridonov SI, et al. A prospective outcomes study of meniscal allograft transplantation. Am J Sports Med, 2010, 38(9): 1804-1812. |
| 14. | Bulgheroni P, Murena L, Ratti C, et al. Follow-up of collagen meniscus implant patients: clinical, radiological, and magnetic resonance imaging results at 5 years. Knee, 2010, 17(3): 224-229. |
| 15. | 章亞東, 侯樹勛, 張軼超, 等. 同種異體半月板移植術(shù)臨床效果的初步分析. 中華關(guān)節(jié)外科雜志(電子版), 2008, 2(6): 19-22. |
| 16. | Bedi A, Kelly NH, Baad M, et al. Dynamic contact mechanics of the medial meniscus as a function of radial tear, repair, and partial meniscectomy. J Bone Joint Surg (Am), 2010, 92(6): 1398-1408. |
| 17. | von Lewinski G, Stukenborg-Colsman C, Ostermeier S, et al. Experimental measurement of tibiofemoral contact area in a meniscectomized ovine model using a resistive pressure measuring sensor. Ann Biomed Eng, 2006, 34(10): 1607-1614. |
| 18. | Flanigan DC, Lin F, Koh JL, et al. Articular contact pressures of meniscal repair techniques at various knee flexion angles. Orthopedics, 2010, 33(7): 475. |
| 19. | Rijk PC, Tigchelaar-Gutter W, Bernoski FP, et al. Functional changes in articular cartilage after meniscal allograft transplantation: a quantitative histochemical evaluation in rabbits. Arthroscopy, 2006, 22(2): 152-158. |
- 1. Stone KR, Adelson WS, Pelsis JR, et al. Long-term survival of concurrent meniscus allograft transplantation and repair of the articular cartilage: a prospective two- to 12-year follow upreport. J Bone Joint Surg (Br), 2010, 92(7): 941-948.
- 2. Harris JD, Cavo M, Brophy R, et al. Biological knee reconstruction: a systematic review of combined meniscal allograft transplantation and cartilage repair or restoration. Arthroscopy, 2010. [Epub ahead of print].
- 3. 朱加亮, 衷鴻賓, 侯樹勛, 等. 異體半月板庫的建立及臨床初步應(yīng)用. 中國矯形外科雜志, 2007, 15(19): 1445-1447.
- 4. Lewis PB, Williams JM. Multiple freeze-thaw cycled meniscal allograft tissue: A biomechanical, biochemical, and histologic analysis. J Orthop Res, 2008, 26(1): 49-55.
- 5. Gelber PE, Gonzalez G, Torres R, et al. Cryopreservation does not alter the ultrastructure of the meniscus. Knee Surg Sports Traumatol Arthrosc, 2009, 17(6): 639-644.
- 6. 康曉琦, 章亞東, 衷鴻賓, 等. 異體半月板移植的實(shí)驗(yàn)研究和臨床應(yīng)用. 實(shí)用骨科雜志, 2008, 14(1): 37-39.
- 7. Flanigan DC, Lin F, Koh J, et al. Articular contact pressures of meniscal repair techniques at various knee flexion angles. Orthopedics, 2010, 33(7): 475.
- 8. Paletta GA Jr, Manning T, Snell E, et al. The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee. A biomechanical study. Am J Sports Med, 1997, 25(5): 692-698.
- 9. Lee DH, Kim SB, Kim TH, et al. Midterm outcomes after meniscal allograft transplantation: comparison of cases with extrusion versus without extrusion. Am J Sports Med, 2010, 38(2): 247-254.
- 10. van der Wal RJ, Thomassen BJ, van Arkel ER. Long-term clinical outcome of open meniscal allograft transplantation. Am J Sports Med, 2009, 37(11): 2134-2139.
- 11. Gomoll AH, Kang RW, Chen AL, et al. Triad of cartilage restoration for unicompartmental arthritis treatment in young patients: meniscus allograft transplantation, cartilage repair and osteotomy. J Knee Surg, 2009, 22(2): 137-141.
- 12. Vundelinckx B, Bellemans J, Vanlauwe J. Arthroscopically assisted meniscal allograft transplantation in the knee: a medium-term subjective, clinical, and radiographical outcome evaluation. Am J Sports Med, 2010, 38(11): 2240-2247.
- 13. LaPrade RF, Wills NJ, Spiridonov SI, et al. A prospective outcomes study of meniscal allograft transplantation. Am J Sports Med, 2010, 38(9): 1804-1812.
- 14. Bulgheroni P, Murena L, Ratti C, et al. Follow-up of collagen meniscus implant patients: clinical, radiological, and magnetic resonance imaging results at 5 years. Knee, 2010, 17(3): 224-229.
- 15. 章亞東, 侯樹勛, 張軼超, 等. 同種異體半月板移植術(shù)臨床效果的初步分析. 中華關(guān)節(jié)外科雜志(電子版), 2008, 2(6): 19-22.
- 16. Bedi A, Kelly NH, Baad M, et al. Dynamic contact mechanics of the medial meniscus as a function of radial tear, repair, and partial meniscectomy. J Bone Joint Surg (Am), 2010, 92(6): 1398-1408.
- 17. von Lewinski G, Stukenborg-Colsman C, Ostermeier S, et al. Experimental measurement of tibiofemoral contact area in a meniscectomized ovine model using a resistive pressure measuring sensor. Ann Biomed Eng, 2006, 34(10): 1607-1614.
- 18. Flanigan DC, Lin F, Koh JL, et al. Articular contact pressures of meniscal repair techniques at various knee flexion angles. Orthopedics, 2010, 33(7): 475.
- 19. Rijk PC, Tigchelaar-Gutter W, Bernoski FP, et al. Functional changes in articular cartilage after meniscal allograft transplantation: a quantitative histochemical evaluation in rabbits. Arthroscopy, 2006, 22(2): 152-158.