科研之友
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摘要
Background: Enhanced primary anterior cruciate ligament repair, in which suture repair is performed in conjunction with a collagen-platelet composite to stimulate healing, is a potential new treatment option for anterior cruciate ligament injuries. Previous studies have evaluated this approach at the time of anterior cruciate ligament disruption. Hypothesis: Delaying surgery by 2 or 6 weeks would have a significant effect on the functional outcome of the repair. Study Design: Controlled laboratory study. Methods: Sixteen female Yorkshire pigs underwent staged, bilateral surgical anterior cruciate ligament transections. Anterior cruciate ligament transection was initially performed on 1 knee and the knee closed. Two or 6 weeks later, enhanced primary repair was performed in that knee while the contralateral knee had an anterior cruciate ligament transection and immediate repair. Bio-mechanical parameters were measured after 15 weeks in vivo to determine the effect of delay time relative to immediate repair on the healing response. Results: Yield load of the repairs at 15 weeks was decreased by 40% and 60% in the groups where repair was delayed for 2 and 6 weeks, respectively (P = .01). Maximum load showed similar results (55% and 60% decrease in the 2- and 6-week delay groups, respectively; P = .011). Linear stiffness also was adversely affected by delay (50% decrease compared with immediate repair after either a 2- or 6-week delay, P =.011). Anterior-posterior laxity after 15 weeks of healing was 40% higher in knees repaired after a 2-week delay and 10% higher in those repaired after a 6-week delay (P = .012) when tested at 30 degrees of flexion, but was not significantly affected by delay when tested at 60 degrees or 90 degrees (P = .21). Conclusion: A delay between anterior cruciate ligament injury and enhanced primary repair has a significant negative effect on the functional performance of the repair.
- 出版日期2010-12
