兔髌骨-髌腱结合部新骨形成与大小预测其愈合程度
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香港中文大学医学院医学委员会研究基金(CUHK4155/02M); AO/ASIF研究基金(Ref.AO/ASIF03-Q26)


New bone formation and its size predicts the repair at patella-patellar tendon healing complex in rabbits
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    摘要:

    目的探讨髌骨-髌腱结合部愈合中新骨形成量和力学指标之间的关系。方法15只雌性成年兔,在一侧后肢的髌骨远端1/3处横行截骨,切除远端1/3髌骨。将髌腱与髌骨断端连接。分别于术后第8和16周取材进行生物力学、组织学和新骨形成情况(X线摄片测量和骨密度测定)检测,进行对比研究。结果髌骨-髌腱结合部新骨面积、新骨长度及骨矿密度在第8和16周之间仍未达到显著性水平,但在第16周时的拉断载荷、极限拉应力和拉断能量均明显大于第8周;新骨面积与拉断载荷及极限拉应力呈显著性相关。结论新骨面积与拉断载荷及极限拉应力间显著相关,通过临床无创X线影像学对新骨面积的定量,可有效评估髌骨部分切除后髌骨-髌腱结合部愈合状况,为术后主动康复提供参考。

    Abstract:

    Objectives To investigate if the radiographically quantifiable new bone would be able to serve as an non- destructive index for predicting healing quality of bone to tendon junction repair in a patella-patellar tendon complex. Methods An established partial patellectomy was performed on 15 mature female rabbits. Patella-patellar tendon (PPT) complex was harvested at 8 (n=7) and 16 weeks (n=8) post-operatively for evaluation of new bone size, length, bone mineral density (BMD), tensile force, strength and energy at failure. Results No significant differences were found in new bone size, length and BMD compared between week 8 and week 16. However, greater failure force, strength and energy were found in week 16 group than that of week 8 group (all p<0.05). The new bone size was found significantly correlated with failure force and strength (p<0.05 for both), but not the new bone length and BMD. Conclusion The findings of this study may suggest that the radiographically quantifiable new bone size formed from the remaining patella after partial patellectomy may serve as a useful non-destructive index in evaluation of the quality of direct bone-tendon repair within PPT healing complex.

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王琳,吕红斌,霍碧君,张颖凯,梁国穗,秦岭.兔髌骨-髌腱结合部新骨形成与大小预测其愈合程度[J].医用生物力学,2006,21(4):291-297

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