The extracellular remodeling of free-soft-tissue autografts and allografts for reconstruction of the anterior cruciate ligament: a comparison study in a sheep model
The extracellular remodeling of free-soft-tissue autografts and allografts for reconstruction of the anterior cruciate ligament: a comparison study in a sheep model
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DOI：
10.1007/s00167-007-0471-0
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发表时间：
2008-04-01
影响因子：
3.8
通讯作者：
Scheffler, S. U.
中科院分区：
文献类型：
--
作者：
Dustmann, M.;Schmidt, T.;Scheffler, S. U.
我们的研究旨在提高目前有限的关于自由软组织肌腱同种异体移植和自体移植用于ACL重建的生物重塑差异的知识。同种异体和自体前交叉韧带重建在羊模型中使用洋地黄浅屈肌腱。6周、12周和52周后处死。我们分析了两种移植物中胶原卷曲的形成及其与收缩性肌成纤维细胞表达的关系。此外，在生物力学测试中比较了结构性能和ap-松弛性。在6周时，自体移植物和同种异体移植物之间仅发现描述性差异，在自体移植物中有更有组织的卷曲模式和肌成纤维细胞分布。12周后发现肌成纤维细胞密度和卷曲形成有显著差异。在这些早期阶段，自体移植物的重建进展比同种异体移植物向中心区域更先进。1年后，两个研究组的移植物恢复到与acl相似的结构。在早期愈合阶段，自体和同种异体移植物的结构特性和ap松弛性没有显著差异。然而，在52周时，失效载荷、刚度和ap-drawer测试显示自体移植ACL重建具有优越的价值。同种异体移植物的细胞外重塑比自体移植物发展得慢。因此，康复程序必须根据移植物和患者的选择进行调整。自体自体ACL重建术后的治疗方案不应直接转移到同种异体ACL重建。
Our study was aimed to advance the currently limited knowledge about differences in the biological remodeling of free soft-tissue tendon allografts and autografts for ACL reconstruction. Allogenic and autologous ACL reconstructions were performed in a sheep model using the flexor digitalis superficialis tendon. After 6, 12 and 52 weeks the animals were sacrificed. We analyzed the collagen crimp formation and its relationship to expression of contractile myofibroblasts in both graft types. Additionally, structural properties and ap-laxity were compared during biomechanical testing. At 6 weeks only descriptive differences were found between autografts and allografts with a more organized crimp pattern and myofibroblast distribution in autografts. Significant differences in myofibroblast density and crimp formation were found after 12 weeks. At these early stages, the progress of remodeling in autografts was more advanced toward the central areas than in allografts. At 1 year, grafts in both study groups returned to an ACL-similar structure. Structural properties and ap-laxity did not vary significantly between auto- and allografts at early healing stages. However, at 52 weeks, failure loads, stiffness and ap-drawer test showed superior values for autograft ACL reconstruction. Extracellular remodeling of allografts develops slower than in autografts. Therefore, rehabilitation procedures will have to be adapted according to graft and patient selection. Postoperative treatment regimens from autograft primary ACL reconstruction should not be directly transferred to allograft ACL reconstructions.