BIOMECHANICS OF ANTERIOR CRUCIATE REPAIR

描述（改编自申请人摘要）：长期目标 目的是改善前牙的手术治疗， 交叉韧带缺陷膝关节，并提供基本信息， 关节组织的愈合和重塑，以及力对关节组织的影响。 愈合和重塑过程。 在当前补助金期间工作 在此期间，申请人开发了设置嫁接力的方法， 术中以特定值测量，然后测量体内力 在功能正常的山羊身上的移植物，以及机械的 移植物的特性作为手术后时间的函数。 迄今为止数据 已经表明，髌骨肌腱移植物中的力，与 人工韧带增强装置（LAD），手术增加 到6周，无论肌腱力最初设置为高或低。 的 6周后，差异载荷分配趋于平衡， 携带近一半的总移植力量，无论是最初的 在手术中设置高或低。 在初始设定力的范围内 测试中，肌腱中的设定力越高， 6周时的功能性力量。 然而，这种功能上的差异 力不足以影响 肌腱，因为3个月时的失效强度相同， 肌腱最初设置为高或低。 这些结论适用于生物移植物的情况， 一个两端固定的左前降支，提供有效的约束， 肌腱 目前还不清楚肌腱将如何反应，如果是 仅移植物的承载元件。 这是一个重要的问题， 这是因为这种结构是最常用的结构， 临床上，因为答案将提供基本信息， 人工关节中力与组织反应相互作用 重建 为了回答这个问题和相关问题，建议的具体目标 研究将髌腱移植物设置在三个力水平， 山羊，以测量在2周和6周时产生的功能移植物力 在手术后和另一个试验组中，测量移植物刚度 和术后3个月的强度。 在目前的工作中， 研究人员注意到， 膝关节;他们将评估移植物固定力与 实验动物的软骨退化 完成后 在上述测试中，他们将在另一组测试中测试接枝性能。 用“标准”重建关节的动物 目前临床上使用的预张力方法，并比较移植物 属性与设置力组的最佳结果。 这将 确定将移植物力设置为 在手术中选择一些值，而不是使用当前的方法， 移植物的力学性能没有得到很好的控制。 其他动物将 测试增加数据到目前的实验，以更坚定地建立 复合移植物中6周时的体内力水平，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.