ANTERIOR CRUCIATE LIGAMENT REPLACEMENT USING PATELLAR TENDON - AN EVALUATION OF GRAFT REVASCULARIZATION IN THE DOG
ANTERIOR CRUCIATE LIGAMENT REPLACEMENT USING PATELLAR TENDON - AN EVALUATION OF GRAFT REVASCULARIZATION IN THE DOG
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DOI：
10.2106/00004623-198264020-00011
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发表时间：
1982-01-01
影响因子：
5.3
通讯作者：
MARSHALL, JL
中科院分区：
文献类型：
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作者：
ARNOCZKY, SP;TARVIN, GB;MARSHALL, JL
用组织学和组织清除（Spalteholz）技术研究了36只狗髌腱移植物替代前交叉韧带的血运重建模式。最初的移植物是无血管的，但6周时，他们完全包被在血管滑膜包膜。髌下脂肪垫的软组织、前交叉韧带的胫骨残端和后滑膜组织促成了这种滑膜血管。髌腱移植物的内在血运重建从移植物的近端和远端部分集中进行，并在20周时完成。髌腱移植物的胫骨附着没有为血运重建过程提供任何血管。1年时，髌腱移植物的血管和组织学外观与正常前交叉韧带相似。在膝关节内移植后，髌腱移植物内立即缺乏灌注血管，移植物的骨插入未能为血运重建过程提供血管，这表明尽管髌腱移植物附着在胫骨上，但在移植时，髌腱移植物基本上是无血管游离移植物。膝关节软组织对移植物血运重建过程的贡献表明，保留和利用髌下脂肪垫和滑膜组织可优化移植物的血运重建和最终存活率。
The revascularization pattern of patellar tendon grafts used to replace the anterior cruciate ligament was studied in 36 dogs by histological and tissue-clearing (Spalteholz) techniques. Initially the grafts were avascular, but by 6 wk they were completely ensheathed in a vascular synovial envelope. The soft tissues of the infrapatellar fat pad, the tibial remnant of the anterior cruciate ligament, and the posterior synovial tissues contributed to this synovial vasculature. Intrinsic revascularization of the patellar tendon graft progressed from the proximal and distal portions of the graft centrally and was complete by 20 wk. The tibial attachment of the patellar tendon graft did not contribute any vessels to the revascularization process. At 1 yr, the vascular and histological appearance of the patellar tendon graft resembled that of a normal anterior cruciate ligament. The absence of perfused vessels within the patellar tendon graft immediately after transplantation within the knee joint and the failure of the osseous insertion of the graft to contribute vessels to the revascularization process suggest that although it is left attached at the tibia, the patellar tendon graft is essentially an avascular free graft at transplantation. The contribution of the soft tissues of the knee to the revascularization process of the graft suggests preservation and utilization of the infrapatellar fat pad and synovial tissue to optimize the graft''s revascularization and ultimate viability.