治疗关节内韧带损伤的选择是有限的,韧带重建不足会导致疼痛的关节不稳定,功能丧失,和退行性关节炎的进行性发展。这项研究旨在评估用于韧带重建的生物增强基质材料的能力,以承受关节内的拉力并增强恢复关节功能所需的韧带再生。
共有18只新西兰兔通过自体移植进行了双侧前交叉韧带重建,FiberTape,或FiberTape增强的自体移植。主要结果是生物力学评估(n=17),microCT(μCT)评估(n=12),组织学评估(n=12),和定量聚合酶链反应(qPCR)分析(n=6)。
八周时,单独的FiberTape或FiberTape增强的自体移植物与自体移植物相比,在最终失效负荷方面表现出增加的生物力学稳定性(p=0.035)。伸长率(p=0.006),和能量吸收(p=0.022)。FiberTape移植的样品还显示骨隧道中的骨矿物质密度增加(p=0.039)。组织学评估显示所有移植物通过新骨形成整合在骨隧道中,和有限的炎症迹象。通过炎症生物标志物的定量证实了在所有样品中缺乏延长的炎症。然而,沿缝合胶带材料未观察到韧带样组织的再生。除了一次自体移植失败,未发现不良事件.
我们的结果表明,FiberTape在经过验证的8周兔模型中增加了关节内韧带重建的生物力学性能。在此期间,FiberTape不会对骨骼隧道的愈合产生不利影响,也不会引起炎症的长期升高。引用这篇文章:骨关节J2019;101-B:1238-1247。
Options for the treatment of intra-articular ligament injuries are limited, and insufficient ligament reconstruction can cause painful joint instability, loss of function, and progressive development of degenerative arthritis. This
study aimed to assess the capability of a biologically enhanced matrix material for ligament reconstruction to withstand tensile forces within the joint and enhance ligament regeneration needed to regain joint function.
A total of 18 New Zealand rabbits underwent bilateral anterior cruciate ligament reconstruction by autograft, FiberTape, or FiberTape-augmented autograft. Primary outcomes were biomechanical assessment (n = 17), microCT (µCT) assessment (n = 12), histological evaluation (n = 12), and quantitative polymerase chain reaction (qPCR) analysis (n = 6).
At eight weeks, FiberTape alone or FiberTape-augmented autograft demonstrated increased biomechanical stability compared with autograft regarding ultimate load to failure (p = 0.035), elongation (p = 0.006), and energy absorption (p = 0.022). FiberTape-grafted samples also demonstrated increased bone mineral density in the bone tunnel (p = 0.039). Histological evaluation showed integration of all grafts in the bone tunnels by new bone formation, and limited signs of inflammation overall. A lack of prolonged inflammation in all samples was confirmed by quantification of inflammation biomarkers. However, no regeneration of ligament-like tissue was observed along the suture tape materials. Except for one autograft failure, no adverse events were detected.
Our results indicate that FiberTape increases the biomechanical performance of intra-articular ligament reconstructions in a verified rabbit model at eight weeks. Within this period, FiberTape did not adversely affect bone tunnel healing or invoke a prolonged elevation in inflammation. Cite this article: Bone Joint J 2019;101-B:1238-1247.