A novel bioabsorbable conduit augments healing of avascular meniscal tears in a dog model
A novel bioabsorbable conduit augments healing of avascular meniscal tears in a dog model
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DOI：
10.1177/0363546507304330
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发表时间：
2007-11-01
影响因子：
4.8
通讯作者：
Fox, Derek B.
中科院分区：
文献类型：
--
作者：
Cook, James L.;Fox, Derek B.
背景：无血管半月板撕裂是一个常见且昂贵的问题，目前的治疗方法有限。假设：一种可生物吸收的管道将允许血管组织向内生长，这与组织学和生物力学证据相关联，证明狗的半月板无血管撕裂愈合优于半月板钻孔。研究设计：对照实验室研究。方法：25只狗接受了内侧关节切开术，在内侧半月板造成前后部撕裂(N=50个撕裂)。这些狗被分配了半月板的治疗方法：导管(n=29)或环钻(n=21)。术后通过主观评分评定跛行情况，并在术后6、12或24周处死动物，通过半月板撕裂拉伸试验评估关节软骨损伤、手术半月板的大体和组织学表现以及最大载荷到破坏的值。当组织学部分完全愈合时，撕裂被认为是生物力学完整性，同时测量的失败负荷显著大于对照组。结果：根据组织学评估，在本研究的12周和24周，在所有的无血管缺损中，管道与完全愈合(n=4)或部分愈合(n=5)相关。经环钻和修复处理的缺损未见愈合。4周后未发现与手术或半月板治疗相关的跛行。所有关节均未发现关节软骨损伤。在12周和24周时，正常半月板的平均载荷(分别为43.2N和28.6N)显著高于正常半月板(P
Background: Avascular meniscal tears are a common and costly problem for which current treatment options are limited.Hypothesis: A bioabsorbable conduit will allow for vascular tissue ingrowth that is associated with histologic and biomechanical evidence for avascular meniscal tear healing superior to that associated with meniscal trephining in dogs.Study Design: Controlled laboratory study.Methods: Twenty-five dogs underwent medial arthrotomy with creation of anterior and posterior tears in the medial menisci (N = 50 tears). The dogs were assigned treatments for their menisci: conduit (n = 29 tears) or trephine (n = 21 tears). Dogs were assessed for lameness by subjective scoring after surgery and sacrificed at 6, 12, or 24 weeks and assessed for articular cartilage damage, gross and histologic appearance of the operated menisci, and maximal load-to-failure values using tensile testing of meniscal tears. Tears were considered to demonstrate biomechanical integrity when histologic partial to complete healing was noted in conjunction with a measured load to failure that was significantly greater than controls.Results: Based on histologic assessment, the conduit was associated with complete (n = 4) or partial (n = 5) healing in all avascular defects at 12 and 24 weeks after surgery in this study. No healing was seen in defects treated by trephination and repair. No lameness associated with surgery or meniscal treatment was noted after 4 weeks. No articular cartilage damage was noted in any joint. At both 12 and 24 weeks, mean load to failure for normal menisci (43.2 N and 28.6 N, respectively) was significantly (P