影响腱-骨愈合因素的研究新进展
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摘要
随着运动爱好者逐渐增多,运动带来的膝关节损伤也与日俱增。前交叉韧带断裂是常见的膝关节运动损伤,目前手术是其主要治疗方法,术中取自体肌腱编制成韧带重建前交叉韧带(Anterior Cruciate Ligament,ACL)。因此,肌腱与骨的愈合直接影响着手术效果。那么,如何加速肌腱与骨的愈合是关节外科医生最关心的问题。近年来研究发现,多种因素可通过改变腱骨结合面的局部微环境对腱-骨愈合起到抑制或促进作用。其中,增强相关生长因子活性、加入自体骨膜、运用中药治疗等措施可加快腱-骨愈合;关节液等不利因素可减慢腱-骨愈合。因此,合理增加有利因素,减少不利因素可缩短愈合周期,加速术后康复,进而提高手术效果。本文就目前影响腱骨愈合因素的最新进展作一综述。
With the more and more people enjoy doing sports, and knee-joint injury becomes common. Injury to anterior cruciate ligament(ACL) is the most common lesions of the knee joint, and taking other tendon instead ACL by surgery is the main treatment.Therefore, tendon and bone healing directly affects the operation effect. Thus, how to accelerate the tendon and bone healing is the most important problem for joint surgeon in recent years. Studies have shown that a variety of factors can inhibit or promote the tendon bone healing by changing the local micro environment of the tendon bone bonding surface. Among them, the enhancement of related growth factor activity, the addition of autologous periosteum, the use of traditional Chinese medicine treatment can accelerate tendon bone healing, and other adverse factors, such as liquid and other adverse factors can slow tendon bone healing. To cut down the treatment period and improve the effect of postoperative recovery, we could reasonably increase the favorable factors and reduce the adverse actors.hen, we would make a review of the recent research on the factors to impact tendon-to-bone.
With the more and more people enjoy doing sports, and knee-joint injury becomes common. Injury to anterior cruciate ligament(ACL) is the most common lesions of the knee joint, and taking other tendon instead ACL by surgery is the main treatment.Therefore, tendon and bone healing directly affects the operation effect. Thus, how to accelerate the tendon and bone healing is the most important problem for joint surgeon in recent years. Studies have shown that a variety of factors can inhibit or promote the tendon bone healing by changing the local micro environment of the tendon bone bonding surface. Among them, the enhancement of related growth factor activity, the addition of autologous periosteum, the use of traditional Chinese medicine treatment can accelerate tendon bone healing, and other adverse factors, such as liquid and other adverse factors can slow tendon bone healing. To cut down the treatment period and improve the effect of postoperative recovery, we could reasonably increase the favorable factors and reduce the adverse actors.hen, we would make a review of the recent research on the factors to impact tendon-to-bone.
引文
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[3]Rothrauff BB,Tuan RS.Cellular therapy in bone-tendon inter face regeneration[J].Organogenesis,2014,10(1):13-28
[4]Kivanc Atesok,Freddie H Fu,Megan R Wolf,et al.Current Concepts Review Augmentation of Tendon-to-Bone Healing[J].J Bone Joint Surg Am,2014,96:513-521
[5]Chen Biao,Li Bin,Qi Yong-jian,et al.Enhancement of tendonto-bonehealing after anterior cruciateligament reconstruction using bonemarrow-derived mesenchymalstem cells genetically modified with b FGF/BMP2[J].Scientific Repo Rts,Published online 2016,12[Epub ahead of print]
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[7]Li Hong,Jiang Jia,Wu Yang,et al.Potential mechanisms of a periosteum patch as an effective and favourable approach to enhance tendon-bone healing in the human body[J].International Orthopaedics,2012,36(3):665-669
[8]Shibata S,Sakamoto Y,Yokohama-Tamaki T,et al.Distribution of matrix proteins in perichondrium and periosteum during the incorporation of Meckel's cartilage into ossifying mandible in midterm human fetuses,an immunohistochemical study[J].Anat Rec(Hoboken),2014,297(7):1208-1217
[9]Ibrahim,Mohamed,Shuid A.Update on statins,hope for osteoporotic fracture healing treatment[J].Curr Drug Targets,2013,14(13):1524-1532
[10]Tai I C,Fu Y C,Wang C K,et al.Local delivery of controlled release simvastatin/PLGA/Hap microspheres enhances bone repair[J].Int J Nanomedicine,2013,8(1):3895-3904
[11]Hamed E,Novitskaya E,Li J,et al.Elastic moduli of untreated,demineralized and deproteinized cortical bone,validation of a theoretical model of bone as an interpenetrating composite material[J].Acta Biomater,2012,8(3):1080-1092
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[13]程志安,韩凌,危建安,等.六味地黄丸、金匮肾气丸及健骨二仙丸含药血清对BMSCs成脂、成骨细胞分化相关基因的影响[J].中国中西医结合杂志,2013,33(2):261-265Cheng Zhi-an,Han Ling,Wei Jian-an,et al.Regulation Effects of Liuwei Dihuang Pill,Jingui Shenqi Pill,Jiangu Erxian Pill Containing Serums on Adipogenicand Osteogenic Differentiationrelated Genes Expressions in the Differentiation Process of Preadipocytes to Osteoblasts[J].Chinese Journal of Integrated Traditional and Western Medicine,2013,33(2):261-265
[14]杨伟毅,潘建科,谢辉,等.补肾中药促进兔前交叉韧带重建术后腱-骨愈合的组织学观察[J].世界中西医结合杂志,2016,11(5):636-666Yang Wei-yi,Pan Jian-ke,Xie Hui,et al.Histological Study of Herbal Medicine for Kidney Tonification on Tendon-Bone Healing after Anterior Cruciate Ligament Reconstruction in Rabbits[J].World Journal of Integrated Traditional and Western Medicine,2016,11(5):636-666
[15]王开龙,黄永,周宾宾.前交叉韧带重建术后超早期中医介入的康复疗效观察[J].中国康复医学杂志,2013,28(7):645-647Wang Kai-long,Huang Yong,Zhou Bin-bin,A study about Chinese medicineon Tendon-Bone Healing after Anterior Cruciate Ligament Reconstruction[J].Chinese Journal of Rehabilitation Medicine,2013,28(7):645-647
[16]罗程,欧阳丽斯,雷万龙,等.红花黄色素对兔前交叉韧带重建术后骨腱愈合影响的生物力学研究[J].解剖学研究,2016,38(3):191-209Luo Cheng,Ouyang Li-si,Lei Wan-long,et al.An biomechamical study on the effect of safflower yellow on bone tendon healing of anterior cruciate ligament reconstruction in rabbits[J].Anat Res,2016,38(3):191-209
[17]庞坚,詹红生,石印玉.石印玉中医骨伤科教案-膝骨关节炎的诊治[J].上海中医药大学学报,2010,24(4):45-48Pang Jian,Zhan Hong-sheng,Shi Yin-yu.Teaching plan Shi Yinyu-The treatment of Osteoarthritis of the knee[J].Acta Universitatis Traditionis Medicalis Sinensis Pharmacologlaeque Shanghai,2010,24(4):45-48
[18]Wang Xiao-xu,Zhai Rong-fan,Yang Jin-tao.Effect of hamstring tendon transfected with adenovirus-mediated transforming growth factorβ1 gene onhistomorphology of tendon-bone interface healing afteranterior cruciate ligament reconstruction in rabbits[J].Chinese Journal of Reparative and Reconstructive Surgery,2015,29(12):1488-1493
[19]Chen B,Qin J,Wang H,et al.Effects of adenovirus-mediated b FGF,IL-1Ra and IGF-1 gene transfer on human osteoarthritic chondrocytes and osteoarthritis in rabbits[J].Exp Mol Med,2010,42:684-695
[20]Feng Z,Ting J,Alfonso Z,et al.Fresh and cryopreserved,uncultured adipose tissue-derived stem and regenerativecells ameliorate ischemia-reperfusion-induced acute kidney injury[J].Nephrol Dial Transplant,2010,25:3874-3884
[21]Kosaka M,Nakase J,Hayashi K,et al.Adipose-Derived Regenerative Cells Promote Tendon-Bone Healing in a Rabbit Model[J].Arthroscopy,2016,32(5):851-859
[22]An■l Ta kesen MD,Baybars Atao lu MD,Mustafazer MD.Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits[J].Eklem Hastal覦k Cerrahisi,2015,26(2):77-83
[23]李艳红,朱莉姗,程媛.透明质酸钠凝胶用于防止宫腔粘连患者术后再粘连的疗效分析[J].中国继续医学教育,2016,8(10):135-136Li Yan-hong,Zhu Li-shan,Cheng Yuan.The Efficacy of Sodium Hyaluronate Gel for Preventing Postoperative Adhesion of Uterine Cavity Adhesion[J].China Continuing Medical Education,2016,8(10):135-136
[24]Sun Lei,Zhou Xian-hua,Wu Bo,et al.Inhibitory Effect of Synovial Fluid on Tendon-to-Bone Healing,An Experimental Study in Rabbits[J].The Journal of Arthroscopic and Related Surgery,2012,28:1297-1305
[25]Wen CY,Qin L,Lee KM,et al.Grafted tendon healing in tibial tunnel is inferior to healing in femoral tunnel after anterior cruciate ligament reconstruction:A histo-morphometric study in rabbits[J].Arthroscopy,2010,26:58-66
[26]Gulotta LV,Kovacevic D,Cordasco F,et al.Evaluation of tumor necrosis factor alpha blockade on early tendon-to-bone healing in a rat rotator cuff repair model[J].Arthroscopy,2011,27:1351-1357
[27]Bi Fang-gang,Yan Shi-gui.Research Progress Of Strategies To Augment Tendon-To-Bone Healing[J].Chin J Joint Surg(Electronic Edition),2015,9(3):407-411
[28]Bedi A,Kovacevic D,Hettrich C,et al.The effect of matrix metalloproteinase inhibition on tendon-to-bone healing in a rotator cuff repair model[J].J Shoulder Elbow Surg,2010,19(3):384-391
[2]Hays PL,Kawamura S,Deng XH,et al.The role of macrophages in early healing of a tendon graft in a bone tunnel[J].J Bone Joint Surg Am,2008,90(3):565-579
[3]Rothrauff BB,Tuan RS.Cellular therapy in bone-tendon inter face regeneration[J].Organogenesis,2014,10(1):13-28
[4]Kivanc Atesok,Freddie H Fu,Megan R Wolf,et al.Current Concepts Review Augmentation of Tendon-to-Bone Healing[J].J Bone Joint Surg Am,2014,96:513-521
[5]Chen Biao,Li Bin,Qi Yong-jian,et al.Enhancement of tendonto-bonehealing after anterior cruciateligament reconstruction using bonemarrow-derived mesenchymalstem cells genetically modified with b FGF/BMP2[J].Scientific Repo Rts,Published online 2016,12[Epub ahead of print]
[6]Wang Zhi-hui,Chen Bai-cheng,Zhang Xiao-yang,et al.Aprospective clinical study on autologous periosteum wrapping tendon allograft for anterior cruciate ligament reconstruction[J].Chinese Journal of Reparative and Reconstructive Surgery,2011,25(10):1256-1260
[7]Li Hong,Jiang Jia,Wu Yang,et al.Potential mechanisms of a periosteum patch as an effective and favourable approach to enhance tendon-bone healing in the human body[J].International Orthopaedics,2012,36(3):665-669
[8]Shibata S,Sakamoto Y,Yokohama-Tamaki T,et al.Distribution of matrix proteins in perichondrium and periosteum during the incorporation of Meckel's cartilage into ossifying mandible in midterm human fetuses,an immunohistochemical study[J].Anat Rec(Hoboken),2014,297(7):1208-1217
[9]Ibrahim,Mohamed,Shuid A.Update on statins,hope for osteoporotic fracture healing treatment[J].Curr Drug Targets,2013,14(13):1524-1532
[10]Tai I C,Fu Y C,Wang C K,et al.Local delivery of controlled release simvastatin/PLGA/Hap microspheres enhances bone repair[J].Int J Nanomedicine,2013,8(1):3895-3904
[11]Hamed E,Novitskaya E,Li J,et al.Elastic moduli of untreated,demineralized and deproteinized cortical bone,validation of a theoretical model of bone as an interpenetrating composite material[J].Acta Biomater,2012,8(3):1080-1092
[12]Lin Jin-xiu,Sun Dong-sheng,Zheng Xiao,et al.Enhancement of tendonbone healing by topical use ofsimvastatin after ACL reconstruction[J].Journal of Shandong University-Health Sciences,2015,53(3):27-31
[13]程志安,韩凌,危建安,等.六味地黄丸、金匮肾气丸及健骨二仙丸含药血清对BMSCs成脂、成骨细胞分化相关基因的影响[J].中国中西医结合杂志,2013,33(2):261-265Cheng Zhi-an,Han Ling,Wei Jian-an,et al.Regulation Effects of Liuwei Dihuang Pill,Jingui Shenqi Pill,Jiangu Erxian Pill Containing Serums on Adipogenicand Osteogenic Differentiationrelated Genes Expressions in the Differentiation Process of Preadipocytes to Osteoblasts[J].Chinese Journal of Integrated Traditional and Western Medicine,2013,33(2):261-265
[14]杨伟毅,潘建科,谢辉,等.补肾中药促进兔前交叉韧带重建术后腱-骨愈合的组织学观察[J].世界中西医结合杂志,2016,11(5):636-666Yang Wei-yi,Pan Jian-ke,Xie Hui,et al.Histological Study of Herbal Medicine for Kidney Tonification on Tendon-Bone Healing after Anterior Cruciate Ligament Reconstruction in Rabbits[J].World Journal of Integrated Traditional and Western Medicine,2016,11(5):636-666
[15]王开龙,黄永,周宾宾.前交叉韧带重建术后超早期中医介入的康复疗效观察[J].中国康复医学杂志,2013,28(7):645-647Wang Kai-long,Huang Yong,Zhou Bin-bin,A study about Chinese medicineon Tendon-Bone Healing after Anterior Cruciate Ligament Reconstruction[J].Chinese Journal of Rehabilitation Medicine,2013,28(7):645-647
[16]罗程,欧阳丽斯,雷万龙,等.红花黄色素对兔前交叉韧带重建术后骨腱愈合影响的生物力学研究[J].解剖学研究,2016,38(3):191-209Luo Cheng,Ouyang Li-si,Lei Wan-long,et al.An biomechamical study on the effect of safflower yellow on bone tendon healing of anterior cruciate ligament reconstruction in rabbits[J].Anat Res,2016,38(3):191-209
[17]庞坚,詹红生,石印玉.石印玉中医骨伤科教案-膝骨关节炎的诊治[J].上海中医药大学学报,2010,24(4):45-48Pang Jian,Zhan Hong-sheng,Shi Yin-yu.Teaching plan Shi Yinyu-The treatment of Osteoarthritis of the knee[J].Acta Universitatis Traditionis Medicalis Sinensis Pharmacologlaeque Shanghai,2010,24(4):45-48
[18]Wang Xiao-xu,Zhai Rong-fan,Yang Jin-tao.Effect of hamstring tendon transfected with adenovirus-mediated transforming growth factorβ1 gene onhistomorphology of tendon-bone interface healing afteranterior cruciate ligament reconstruction in rabbits[J].Chinese Journal of Reparative and Reconstructive Surgery,2015,29(12):1488-1493
[19]Chen B,Qin J,Wang H,et al.Effects of adenovirus-mediated b FGF,IL-1Ra and IGF-1 gene transfer on human osteoarthritic chondrocytes and osteoarthritis in rabbits[J].Exp Mol Med,2010,42:684-695
[20]Feng Z,Ting J,Alfonso Z,et al.Fresh and cryopreserved,uncultured adipose tissue-derived stem and regenerativecells ameliorate ischemia-reperfusion-induced acute kidney injury[J].Nephrol Dial Transplant,2010,25:3874-3884
[21]Kosaka M,Nakase J,Hayashi K,et al.Adipose-Derived Regenerative Cells Promote Tendon-Bone Healing in a Rabbit Model[J].Arthroscopy,2016,32(5):851-859
[22]An■l Ta kesen MD,Baybars Atao lu MD,Mustafazer MD.Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits[J].Eklem Hastal覦k Cerrahisi,2015,26(2):77-83
[23]李艳红,朱莉姗,程媛.透明质酸钠凝胶用于防止宫腔粘连患者术后再粘连的疗效分析[J].中国继续医学教育,2016,8(10):135-136Li Yan-hong,Zhu Li-shan,Cheng Yuan.The Efficacy of Sodium Hyaluronate Gel for Preventing Postoperative Adhesion of Uterine Cavity Adhesion[J].China Continuing Medical Education,2016,8(10):135-136
[24]Sun Lei,Zhou Xian-hua,Wu Bo,et al.Inhibitory Effect of Synovial Fluid on Tendon-to-Bone Healing,An Experimental Study in Rabbits[J].The Journal of Arthroscopic and Related Surgery,2012,28:1297-1305
[25]Wen CY,Qin L,Lee KM,et al.Grafted tendon healing in tibial tunnel is inferior to healing in femoral tunnel after anterior cruciate ligament reconstruction:A histo-morphometric study in rabbits[J].Arthroscopy,2010,26:58-66
[26]Gulotta LV,Kovacevic D,Cordasco F,et al.Evaluation of tumor necrosis factor alpha blockade on early tendon-to-bone healing in a rat rotator cuff repair model[J].Arthroscopy,2011,27:1351-1357
[27]Bi Fang-gang,Yan Shi-gui.Research Progress Of Strategies To Augment Tendon-To-Bone Healing[J].Chin J Joint Surg(Electronic Edition),2015,9(3):407-411
[28]Bedi A,Kovacevic D,Hettrich C,et al.The effect of matrix metalloproteinase inhibition on tendon-to-bone healing in a rotator cuff repair model[J].J Shoulder Elbow Surg,2010,19(3):384-391