An experimental study of stored-tendon allograft following discectomy in the rabbit temporomandibular joint.

关节盘对颞下颌关节具有重要的生物力学功能。然而，病理性椎间盘必须从疼痛的难治性内紊乱或骨关节炎性颞下颌关节中切除。目前还没有理想的间置材料可以保护关节软骨免受椎间盘切除后的退行性关节炎。本研究的目的是评价在兔颞下颌关节盘切除后，用储存的同种异体肌腱替代盘的保护作用。将白色家兔分为3个手术组：第1组，仅行单侧椎间盘切除术。第2组，经戊二醛（GA）处理的同种异体肌腱在椎间盘切除术后作为间置材料移植。第3组，椎间盘切除术后移植环氧树脂（E）处理的同种异体肌腱。GA或E被用作肌腱胶原的交联剂。术后3个月处死动物。将颞下颌关节整块切除，组织学处理并用苏木精和伊红染色。椎间盘切除术后，用E处理的同种异体肌腱移植物置换椎间盘似乎可以获得有希望的短期结果。GA处理的同种异体肌腱移植物对髁突关节软骨也有保护作用。然而，在大多数系列中，GA处理的和E处理的同种异体肌腱移植物在颞下颌关节盘去除后难以存活。肌腱移植物收缩或吸收的风险没有得到预防。

The disc has important biomechanical functions for the temporomandibular joint. However, the pathologic disc has to be removed from painful refractory internally deranged or osteoarthritic temporomandibular joint. There are no ideal interpositional materials at present that can protect articular cartilage from degenerative arthritis following discectomy. The aim of this study is to evaluate the protective effect of disc replacement with stored tendon allograft after disc removal in the rabbit temporomandibular joint.Thirty Japanese. white rabbits were divided into 3 surgical groups as follows : In group 1, unilateral discectomy alone was carried out. In group 2, glutaraldehyde(GA)treated allogenic tendon was grafted as an interpositional material after discectomy. In group 3, epoxy(E)treated allogenic tendon was grafted after discectomy. GA or E was used as a cross-linking agent for tendon collagen. The animals were killed at 3rd post-operative month. The TMJs were removed en bloc, histologically processed and stained with hematoxylin and eosin.Disc replacement with E-treated tendon allografts seems to give promising short-term results following discectomy. GA-treated tendon allografts also have protective effects on condylar articular cartilage. However, in most series, the both GA-treated and Etreated tendon allografts were difficult to survive after disc removal in the temporomandibular joint. The risk of tendon-graft shrinkage or resorption was not prevented.