HEALING OF THE MCL--INTERDISCIPLINARY STUDIES

内侧副韧带(MCL)损伤年发病率 据估计，美国有超过6万人，三分之一 并伴有前十字韧带(ACL)损伤。 临床上，损伤的MCL无需手术即可愈合。 干预；然而，动物研究表明， 愈合的组织的比例不会恢复到受伤前的水平，即使在 一年。有人担心，治疗效果不佳，尤其是 MCL+前交叉韧带联合损伤，可导致膝关节残疾。 虽然已经推荐了许多治疗方法，但仍有 对于治疗的方法没有达成一致的意见 MCL+前交叉韧带损伤。因此，这项研究的目的是 系统地找出提高创面愈合的方法 用生长因子损伤MCL。四个具体目标是 建议：1)EGF、PDGF-BB、β-成纤维细胞生长因子和转化生长因子-β1 应用于山羊MCL成纤维细胞，然后分离MCL损伤 确定最佳生长因子和最佳剂量。2)网络的影响 MCL愈合的最佳生长因子治疗将是 前交叉韧带合并前交叉韧带损伤的探讨 重建。3)基因转移技术，允许重复 经皮将生长因子输送到损伤部位，将 探索过了。4)MCL+前交叉韧带合并前交叉韧带损伤 重建将用于研究生长因子的影响 损伤后长达2年的MCL愈合和重塑。vbl.使用 一种跨学科的方法，形态，生化和 将评估MCL愈合的生物力学特性并 相互关联。形态分析将包括粗略的、 组织学和超检查。生物力学评估将 包括关节不稳定性的测量以及拉伸和 粘弹性行为。生化评估将涉及 蛋白质多聚糖的定量和分类及 胶原蛋白的含量、类型和交联度的测定。 根据已发表和正在进行的研究，增长因素将有助于 MCL愈合和重塑，同时基因转移技术 为重复经皮给药提供了一个令人兴奋的机会 增长因素的影响。从这项研究中获得的知识将 增加我们对MCL愈合机制的理解， 这也可以应用于其他韧带。

The annual incidence of medial collateral ligament (MCL) injuries in the U.S. is estimated to be greater than 60,000, one-third of which have concomitant anterior cruciate ligament (ACL) injuries. Clinically, the injured MCL can heal without operative intervention; however, animal studies have shown that the quality of the healed tissue does not return to pre-injury levels, even after one year. There are concerns that suboptimal healing, especially of combined MCL+ACL injuries, can lead to knee disability. Although many treatment methods have been recommended, there is no consensus of opinion regarding the therapeutic approach to MCL+ACL ligament injuries. Thus, the objective of this study is to systematically identify methods for improving the healing of the injured MCL with growth factors. Four specific aims are proposed: 1) EGF, PDGF-BB, betaFGF and TGF-beta1 will be applied to goat MCL fibroblasts and then isolated MCL injuries to identify the best growth factor and optimal dose. 2) The effects of the optimal growth factor treatment on MCL healing will then be explored in a combined- MCL+ACL injury with ACL reconstruction. 3) Gene transfer technology, which allows repeated percutaneous delivery of growth factors to the injury site, will be explored. 4) The combined MCL+ACL injury with ACL reconstruction will be used to study the effects of growth factors on MCL healing and remodeling up to 2 years post-injury. Using an interdisciplinary approach, the morphological, biochemical, and biomechanical properties of MCL healing will be evaluated and correlated. Morphological analyses will consist of gross, histological, and ultra examination. Biomechanical evaluation will consist of measurements of joint instability as well as tensile and viscoelastic behaviors. Biochemical evaluation will involve the quantification and classification of proteoglycans and the determination of content, typing and cross-linking of collagen. Based on published and ongoing studies, growth factors will aid MCL healing and remodeling, while gene transfer technology offers an exciting opportunity for repeated percutaneous delivery of growth factors. The knowledge gained from this study will increase our understanding of the mechanisms of MCL healing, which could be applied to other ligaments.