發(fā)布時間：2018-07-05 14:49

  本文選題：前交叉韌帶 + 腱骨愈合�。� 參考：《中國矯形外科雜志》2017年06期

【摘要】：[目的]探討腺病毒介導TGFβ1基因轉(zhuǎn)染半腱肌腱重建對兔ACL術(shù)后腱骨愈合的生物力學影響。[方法]新西蘭兔48只,隨機分為A、B、C三組,A組自體同側(cè)轉(zhuǎn)染Ad TGFβ1的半腱肌腱;B組自體同側(cè)轉(zhuǎn)染Ad GFP的半腱肌腱;C組自體同側(cè)半腱肌腱DMEM處理,以兔雙側(cè)后肢單股半腱肌腱轉(zhuǎn)染成功后重建ACL,術(shù)后第2周、4周、8周、12周處死取材,檢測生物力學特性變化。[結(jié)果]A、B組半腱肌腱轉(zhuǎn)染后,均可見綠色熒光表達;A組轉(zhuǎn)染12 h時半腱肌腱組織中TGF-β1蛋白表達量為(221.0±12.2)ng/ml;每組兩兩比較,術(shù)后第2周,A、B、C三組移植物分別出現(xiàn)7例、6例、7例骨隧道中拔出,1例、2例、1例撕裂,差異無統(tǒng)計學意義(P0.05);術(shù)后第4周,A、B、C三組肌腱移植物分別出現(xiàn)6例、6例、7例骨隧道中拔出,2例、2例、1例撕裂,差異無統(tǒng)計學意義(P0.05);術(shù)后第8周,A、B、C三組移植物分別出現(xiàn)1例、6例、6例骨隧道中拔出,7例、2例、2例撕裂,差異有統(tǒng)計學意義(P0.05);術(shù)后第12周,A、B、C三組移植物分別出現(xiàn)1例、2例、2例骨隧道中拔出,7例、6例、6例撕裂,差異無統(tǒng)計學意義(P0.05)。術(shù)后第2周,每組最大拉伸載荷差異無統(tǒng)計學意義(P0.05);術(shù)后第4周、8周、12周A組的最大載荷較B、C組明顯增高,差異有統(tǒng)計學意義(P0.05),對比之下,A組及B組差異無統(tǒng)計學意義(P0.05);隨時間的推移,每組的剛度增加,但是組間差異均無統(tǒng)計學意義(P0.05)。術(shù)后第2周,每組最大拉伸載荷差異無統(tǒng)計學意義(P0.05);術(shù)后第4周、8周、12周A組的最大載荷較B、C組明顯增高,差異有統(tǒng)計學意義(P0.05),對比之下,A組及B組差異無統(tǒng)計學意義(P0.05);隨時間的推移,每組的剛度增加,但是組間差異均無統(tǒng)計學意義(P0.05)。[結(jié)論]腺病毒介導TGFβ1基因體外轉(zhuǎn)染對自體半腱肌腱重建兔ACL術(shù)后早期可提供腱骨界面強大的抗拉強度,對膝關(guān)節(jié)早期康復有重要的意義。
[Abstract]:[objective] to investigate the biomechanical effects of adenovirus mediated TGF 尾 1 gene transfer on tendon healing after ACL in rabbits. [methods] Forty-eight New Zealand rabbits were randomly divided into three groups: group A: autogenous ipsilateral transfection of Ad TGF- 尾 1 semitendinosus tendon, group B: autogenous ipsilateral transfection of Ad GFP semitendinosus tendon, group C autogenous ipsilateral semitendinosus tendon DMEM treatment. ACLs were reconstructed with unilateral semitendinosus tendon of bilateral hind limbs after transfection. After 2 weeks, 4 weeks, 8 weeks and 12 weeks after operation, the specimens were sacrificed and the biomechanical characteristics were detected. [results] the expression of TGF- 尾 1 protein in semitendinosus tendon of group A was (221.0 鹵12.2) ng / ml at 12 h after transfection of semitendinosus tendon. In the second week after operation, 7 cases of bone tunnel were found in 7 cases and 6 cases of bone tunnel were found in the three groups of bone grafts. One case was pulled out of the bone tunnel in 2 cases, 2 cases had tears, and 1 case had tears. There was no significant difference between the three groups (P0.05), 6 cases of tendon grafts appeared in 6 cases and 7 cases of bone tunnel were found in the 3 groups at the 4th week after operation, 2 cases were pulled out of bone tunnel, 2 cases had tears, 2 cases had tears. There was no significant difference between the three groups (P0.05), in the 8th week after operation, 1 case (6 cases) and 6 cases (6 cases) of bone tunnel were found in the three groups of bone grafts, 7 cases (7 cases) were pulled out of the bone tunnel, 2 cases (2 cases) had tears, and 2 cases (2 cases) had tears. The difference was statistically significant (P0.05), and there was no significant difference among the 3 groups (1 case, 2 cases, 2 cases, bone tunnel, 7 cases) and 6 cases (6 cases), the difference was not statistically significant (P0.05). At the second week after operation, there was no significant difference in the maximum tensile load in each group (P0.05), but the maximum load in group A was significantly higher than that in group B C at the 4th week and 12th week after operation. The difference was statistically significant (P0.05). There was no significant difference between group A and group B (P0.05). With the passage of time, the stiffness of each group increased, but there was no significant difference between groups (P0.05). At the second week after operation, there was no significant difference in the maximum tensile load in each group (P0.05), but the maximum load in group A was significantly higher than that in group B C at the 4th week and 12th week after operation. The difference was statistically significant (P0.05). There was no significant difference between group A and group B (P0.05). With the passage of time, the stiffness of each group increased, but there was no significant difference between groups (P0.05). [conclusion] Adenovirus-mediated TGF 尾 1 gene transfection in vitro can provide a strong tensile strength at the interface of tendon and bone in the early stage of reconstruction of rabbit ACL with autologous semitendinosus tendon, which is of great significance for early rehabilitation of knee joint.
【作者單位】： 南華大學附屬第二醫(yī)院關(guān)節(jié)外科;
【基金】：湖南省教育廳資助項目(編號:13c836)
【分類號】：R687.4

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