BIOMECHANICS OF ANTERIOR CRUCIATE REPAIR

描述(改编自申请人的摘要)：长期目标 这项工作的目的是改进前路的手术治疗 十字韧带缺乏膝关节，并提供基本信息在 关节组织的愈合和重塑，以及力对关节的影响 愈合和重塑的过程。在目前的拨款期间工作 在此期间，申请者开发了设置贪污力量的方法 在手术中，然后测量体内的力 关于功能正常的山羊的移植物，以及机械性的 移植物的特性作为手术后时间的函数。迄今为止的数据 已经证明了在移植物中的力量，与之平行的 手术后增加的合成韧带增强器(LAD) 至6周时，肌腱力初始设定为高还是低。这个 不同的负荷分担均匀了6周，所以肌腱 携带了近一半的移植力量，无论是最初的 在手术时设定高或低。在初始设定的力量范围内 经过测试，肌腱中较高的成形力往往会导致较高的 6周时的功能作用力。然而，这种功能上的差异 力不足以影响材料的性能 肌腱，因为在3个月的破坏强度是相同的 肌腱最初被设定为高或低。 这些结论适用于生物移植物同时存在的情况 两端刚性固定的法兰，有效地约束了 肌腱。目前还不清楚肌腱会如何反应，如果 只有移植物的承重元件。这是一个重要的问题， 都是因为这种结构是最常用的一种 在临床上，因为答案将在 移植物关节内力与组织反应的相互作用 重建。 为了回答这一问题和相关问题，拟议的 研究目的是将移植物设置为三种力水平。 山羊，在2周和6周时测量由此产生的功能移植物的力 手术后，在另一个试验组中，测量移植物的硬度 术后3个月肌力恢复。在目前的工作中， 研究人员注意到重建的软骨发生了变性。 膝盖；他们将评估移植物成形力和 实验动物的软骨也发生了退化。完成后 在上述测试中，他们将在另一套测试中测试嫁接性能 用“标准”重建关节的动物 目前临床上使用的预张力法，并与植骨进行比较 属性，并在设置的力组中获得最佳结果。这将是 确定将贪污力量设置为 一些人选择了手术价值，而不是使用目前的方法，其中 嫁接机制没有得到很好的控制。其他动物将会是 经过测试，将数据添加到当前的实验中，以更牢固地建立 复合移植物在6周时的体内作用力水平，并验证2 周校准数据。

DESCRIPTION (Adapted from the Applicant's Abstract): The long-term goal of this work is to improve the surgical treatment of the anterior cruciate ligament deficient knee, and to provide basic information in healing and remodeling of joint tissues, and the effect of force on the healing and remodeling processes. In work during the current grant period, the applicants developed methods to set graft forces intraoperatively at specific values, and then measure the in vivo forces on the graft in the functioning goat, as well as the mechanical properties of the graft as a function of time from surgery. Data to date have shown that the force in a patellar tendon graft, in parallel with a synthetic ligament augmentation device (LAD), increased from surgery to 6 weeks, whether the tendon force was initially set high or low. The differential load sharing evened out by 6 weeks so that the tendon carried close to half of the total graft force, whether it was initially set high or low at surgery. Over the range of initial set forces tested, higher set forces in the tendon tended to result in higher functional forces at 6 weeks. However, this difference in functional force was not sufficient to affect the material properties of the tendon, since the failure strength at 3 months was the same whether the tendon was initially set high or low. These conclusions apply to the case of a biologic graft in parallel with an LAD fixed rigidly at both ends, providing an effective constraint to the tendon. It is unclear how the tendon would respond it if were the only load carrying element of the graft. This is an important question, both because this type of construction is the one most often used clinically, and because the answer will provide basic information in the interaction of force and tissue response in a joint with graft reconstruction. To answer this and related questions, the Specific Aims of the proposed research are to set patellar tendon grafts at three force levels in the goat, to measure the resulting functional graft forces at 2 and 6 weeks after surgery, and in another test group, to measure the graft stiffness and strength at 3 months after surgery. During current work, the investigators have noticed cartilage degeneration in the reconstructed knees; they will assess the correlation between graft set force and cartilage degeneration in the test animals as well. After completing the above tests, they will test the graft properties in another set of animals in which the joint is reconstructed with the "standard" pretension method currently used clinically, and compare graft properties with the best results of the set force groups. This will establish whether there is any advantage to setting the graft force to some chosen value at surgery, rather than use the current method in which the graft mechanics are not well-controlled. Additional animals will be tested to add data to the current experiments to more firmly establish in vivo force levels at 6 weeks in a composite graft, and to verify 2 week calibration data.