前交叉韧带断裂对外侧半月板影响的生物力学和组织学研究
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摘要
前交叉韧带(anterior cruciate ligament,ACL)的主要作用是控制胫骨的前移和旋转,也参与膝内外翻的调节。半月板是膝关节的重要组成部分,具有吸收震荡、传递负荷、维持膝关节稳定等重要功能。随着MRI、关节镜手术等诊疗水平的提高,越来越多的ACL损伤得到早期诊断和治疗。同时发现,ACL损伤常继发关节软骨退变;然而ACL损伤是否影响外侧半月板,目前研究甚少。本研究拟采用生物力学测定的方法,观察ACL完全断裂和部分断裂对外侧半月板各部位应变的影响;并运用组织学方法,观察ACL完全断裂后外侧半月板组织形态学的变化,同时检测IL-1β、MMP13的表达,以了解其在外侧半月板退变中的作用机制;测量ACL完全或部分断裂后外侧半月板的周缘性移位及其程度,为ACL损伤是否对外侧半月板产生影响提供理论依据。
第一章前交叉韧带断裂对外侧半月板生物力学特性的影响
目的探讨ACL断裂对外侧半月板生物力学的影响。
方法新鲜正常成人膝关节标本10具作为ACL完整组,在200N、400N、600N、800N载荷下,测试膝关节0°、30°、60°、90°位外侧半月板前角、体部和后角的应变,测试完毕后随机将标本造模成前内侧束(AMB)断裂组和后外侧束(PLB)断裂组,各5具,在上述条件下测试,最后再将10具标本的ACL完全切断进行测试。
结果1.膝关节0°位,在200N、400N载荷下,前角、体部、后角的应变在PLB切断组和ACL全断组、ACL完整组和AMB切断组之间无显著性差异,P＞0.05;在600N、800N载荷下各实验组之间有显著性差异,P＜0.05,前角和体部应变绝对值表现为全断组＞PLB切断组＞AMB切断组＞完整组,后角应变绝对值表现为全断组＜PLB切断组＜AMB切断组＜完整组。2.膝关节30°位,在200N、400N载荷下,前角、体部、后角的应变在ACL完整组和PLB切断组、AMB切断组和ACL全断组之间无显著性差异,P＞0.05;在600N、800N载荷下各实验组之间有显著性差异,P＜0.05,应变绝对值表现为全断组＞AMB切断组＞PLB切断组＞完整组。3.膝关节60°、90°位,相同载荷下各实验组应变之间有显著差异,P＜0.05,应变绝对值表现为全断组＞AMB切断组＞PLB切断组＞完整组。
结论1.ACL完全断裂,对外侧半月板前角、体部和后角的应变均有影响。2.在200N和400N载荷下,AMB切断在膝关节0°位和PLB切断在膝关节屈曲30°位对外侧半月板前角、体部和后角的应变均无影响。3.在600N和800N载荷下,AMB切断在膝关节0°位和PLB切断在屈膝30°、60°、90°位对外侧半月板前角、体部和后角的应变均有影响。4.在各实验载荷下,AMB切断在屈膝30°、60°、90°位和PLB切断在膝0°位对外侧半月板前角、体部和后角的应变均有影响。
第二章前交叉韧带断裂后外侧半月板退变的组织学研究
目的探讨ACL断裂对外侧半月板组织学的影响。
方法48只家兔膝关节配对为实验侧和对照侧,实验侧行ACL切断造模,造模后第1、3、6、8周各随机处死12只,行外侧半月板大体观察,并进行HE染色,免疫组化检测IL-1β、MMP13表达。
结果1.大体观察,随时间延长,实验组外侧半月板出现磨损,甚至撕裂,呈黄色,弹性差。2.组织学观察,随时间延长,半月板表面不平整,组织疏松,胶原纤维排列紊乱,炎性细胞浸润,间质水肿,软骨细胞变性减少。各实验组和对照组组织学退变评分均有显著性差异,P＜0.05。3.实验组IL-1β、MMP13表达均高于对照组,有显著性差异,P＜0.05。4.实验组IL-1β表达阳性率第3周高于第1周和第8周,有显著性差异,P＜0.05;实验组第6周高于第1周和第8周,有显著性差异,P＜0.05;实验组第8周IL-1β表达阳性率高于第1周,有显著性差异,P＜0.05;实验组第3周和第6周IL-1β表达阳性率无显著性差异,P＞0.05。6.实验组MMP13阳性表达率第3周高于第1周、第8周,均有显著性差异,P＜0.05;实验组MMP13阳性表达率第6周高于第8周和第1周,有显著性差异,P＜0.05;实验组MMP13阳性表达率第1周和第8周,有显著性差异,P＜0.05;实验组MMP13阳性表达率第3周和第6周无显著性差异,P＞0.05。
结论1.ACL断裂可引起外侧半月板组织退变。2.IL-1β、MMP13在ACL断裂膝关节外侧半月板中的表达呈先增高后降低的变化规律。3.IL-1β、MMP13表达增高提示IL-1β、MMP13可能是继发外侧半月板退变的因素之一。4.首次制定了半月板退变组织学评分标准。
第三章前交叉韧带断裂对外侧半月板周缘性移位影响的研究
目的探讨ACL断裂对外侧半月板周缘性移位的影响以及断裂程度与周缘性移位程度之间的关系。
方法新鲜正常成人膝关节标本10具作为ACL完整组,在200N、400N、600N、800N载荷下,测量膝关节0°、30°、60°、90°位外侧半月板周缘性位移,测量完毕后随机将标本造模成前内侧束(AMB)断裂组和后外侧束(PLB)断裂组,各5具,在上述条件下测量,最后再将10具标本的ACL完全切断作为全断组进行测量。
结果1.ACL完整时的外侧半月板移位分布在0.5～2.7mm。2.膝关节屈曲0°,在200N、400N、600N载荷下,全断组和PLB切断组、完整组和AMB切断组外侧半月板移位无显著性差异,P＞0.05;完整组和PLB切断组、全断组和完整组、AMB切断组和PLB切断组外侧半月板移位均有显著性差异,P＜0.05;在800N载荷下,各组外侧半月板移位均有显著性差异,P＜0.05。3.膝关节屈曲30°、60°,在200N、400N载荷下,完整组和PLB切断组、AMB切断组和全断组外侧半月板移位均无显著性差异,P＞0.05,其余各组间外侧半月板移位均有显著性差异,P＜0.05;在600N、800N载荷下各组间外侧半月板移位均有显著性差异,P＜0.05。4.膝关节屈曲90°,在200N载荷下,完整组和PLB切断组、AMB切断组和全断组外侧半月板移位均无显著性差异,P＞0.05,其余各组间外侧半月板移位均有显著性差异,P＜0.05;在400N、600N、800N载荷下各组间外侧半月板移位均有显著性差异,P＜0.05。
结论1.外侧半月板生理性移位范围为0.5～2.7mm。2.AMB断裂后外侧半月板在膝关节屈曲时移位明显增大。3.PLB断裂后外侧半月板在膝关节伸直时移位明显增大。4.ACL完全断裂后外侧半月板在膝关节屈曲、伸直时移位均明显增大。5.ACL损伤后外侧半月板移位明显,提示ACL损伤是外侧半月板退变的原因之一。
The anterior cruciate ligament(ACL) is a stable structure whose main role is controlling the antedisplacement of tibial and regulating the rotation of tibial as well as the varus and valgus of knee joint partly.The role of the lateral meniscus which is an important ingredient of the knee is shock absorption and stress transmission and stabilization of the knee joint.With the development of MRI and arthroscope,early diagnosis and treatment of ACL injury turns to be easily achieved,meanwhile,it is found that the secondary injury of ACL deficiency always occurs in articular cartilage,but it is little known whether deficiency of ACL effects on the lateral meniscus.In this study,straining changes in several sites of lateral meniscus caused by ACL injury is observed through biomechanics approach;histological changes of meniscus and expression of IL-1βand MMP13 in meniscus are observed so as to investigate the function of IL-1βand MMP13 in degeneration of lateral meniscus;circumferentia displacement of lateral meniscus after ACL injury is measured,so as to provide theoretical evidence whether deficiency of ACL effects on the lateral meniscus.
ChapterⅠThe Effect of ACL Rupture on the Biomechanics of Lateral Meniscus
OBJECTIVE The effect of ACL injury on all locations of lateral meniscus by measuring biomechanics is observed so as to explore the mechanism of lateral meniscus injury after ACL rupture.
METHOD The straining of lateral meniscus anterior horn, caudomedial part and posterior horn in all fresh normal adult knee joint specimens including 10 specimens of complete ACL,5 of anteriomedialis bundle(AMB) rupture,5 of post-lateral bundle rupture and 10 of complete rupture ACL are tested when the knee joints loaded 200N,400N,600N and 800N at 0°,30°,60°and 90°of flexion.
RESULT 1.The straining of lateral meniscus anterior horn, caudomedial part and posterior horn shows no significant difference between PLB rupture group and ACL complete rupture group,complete ACL group and AMB rupture group under the load of 200N and 400N at 0°of flexion,P＞0.05;significant difference is showed among all the groups under the loads of 600N and 800N at 0°of flexion,P＜0.05; under the same load and angle of flexion,the correlation of the absolute value of straining in every group of lateral meniscus anterior horn and caudomedial part increases in this way of ACL complete rupture group＞PLB rupture group＞AMB rupture group＞complete ACL group,and of posterior horn increases in this way of ACL complete rupture group＜PLB rupture group＜AMB rupture group＜complete ACL group. 2.The straining of lateral meniscus anterior horn,caudomedial part and posterior horn shows no significant difference between AMB rupture group and ACL complete rupture group,complete ACL group and PLB rupture group under the loads of 200N and 400N at 30°of flexion,P＞0.05;significant difference is showed among all the groups under the load of 600N and 800N at 30°of flexion,P＜0.05;under the same load and angle of flexion,the correlation of the absolute value of straining in every group increases in this way of ACL complete rupture group＞AMB rupture group＞PLB rupture group＞complete ACL group.3.There is significant difference among all the groups under the load of 200N,400N,600N and 800N at 60°and 90°of flexion,P＜0.05.under the same load and angle of flexion,the correlation of the absolute value of straining in every group increases in this way of ACL complete rupture group＞AMB rupture group＞PLB rupture group＞complete ACL group.
CONCLUSION 1.ACL complete rupture is likely to cause abnormal straining in all regions of lateral meniscus under different load and angle of flexion.2.Under the load of 200N and 400N,AMB rupture at 0°of flexion and PLB rupture at 30°of flexion cause no effect on the straining in all regions of lateral meniscus.3.Under the load of 600N and 800N,AMB rupture at 0°of flexion and PLB rupture at 30°,60°and 90°of flexion cause apparently effect on the straining in all regions of lateral meniscus.4.Abnormal straining in all regions of lateral meniscus can be caused by PLB rupture at 0°of flexion and AMB rupture at 30°,60°and 90°of flexion under different load.
ChapterⅡThe Research of Histology about Degeneration of Lateral Meniscus after Rupture of ACL
OBJECTIVE Study the effect on lateral meniscus which was caused by rupture of ACL.
METHOD Lateral meniscus of 48 rabbits matched mode pairs both in experiment side which ACL were transacted and control side,at the 1~(st),3~(rd),6~(th) and 8~(th) week,execute 12 rabbits randomly,then to observe lateral meniscus in general and through HE staining and immunohistochemistry staining,detect the expression of IL-1βand MMP13.
RESULT 1.The observation in general showed that along with the increase of the time lateral meniscus of experiment group gradually wore,even ruptured,presenting yellow and bad elasticity.2.Along with the increase of the time the observation of histology shows uneven surface of meniscus,loose tissue,disorder of collagen fibers,infiltration of inflammatory cell,interstitial edema and deformation of intracytoplasm mitochondrion in the chondrocytes.Histological evaluation of the degeneration in fibrocartilage of meniscus in both groups:The scores at the 1~(st),3~(rd),6~(th) and 8~(th) week were higher in the experimental group than those in the control group,showing significant difference,P＜0.05; the scores of experimental group at the 6~(th) and 8~(th) week was higher than that at the 1~(st) and 3~(rd) week,showing significant difference,P＜0.05,but there is no significant difference between the 1~(st) and 3~(rd) week,P＞0.05.3.At the 1~(st),3~(rd),6~(th)and 9~(th) week,expression of IL-1βand MMP13 is higher in experimental group than that in control group,showing significant difference,P＜0.05.4.In experimental group,expression of IL-1βis higher at the 3~(rd) than that at 1~(st) and 8~(th) week,showing significant difference,P＜0.05,expression of IL-1βis higher at the 6~(th) week than that at 1~(st) and 8~(th) week,showing significant difference,P＜0.05,expression of IL-1βis higher at the 8~(th) week than that at 1~(st) week,showing significant difference,P＜0.05,but there is no significant difference between the 3~(rd) and 6~(th) week.5.In experimental group, expression of MMP13 is higher at the 3~(rd) week than that at 1~(st) and 8~(th) week,showing significant difference,P＜0.05,expression of MMP13 is higher at the 6~(th) week than that at 1~(st) and 8th week,showing significant difference,P＜0.05,expression of MMP13 is higher at the 8~(th) week than that at 1~(st) week,showing significant difference,P＜0.05,but there is no significant difference between the 3~(rd) and 6~(th)week,P＞0.05.
CONCLUSION 1.Rupture of ACL could cause the degeneration of lateral meniscus.2.A regularity of expression of IL-1βand MMP13 is displayed that the expression is increasing in primal stage and decreasing in advanced stage after rupture of ACL 3.The high expression of IL-1βand MMP13 hints that IL-1βand MMP13 maybe a promotional factor which causes the degeneration of lateral meniscus.4.The histological evaluation criterion of degeneration of meniscus was made first time.
ChapterⅢThe Effect of ACL Rupture on the Circumferential Displacement of Lateral Meniscus
OBJECTIVE To explore the effect of ACL rupture on lateral meniscus circumferentia displacement and the correlation between the degree of ACL rupture and circumferentia displacement.
METHOD The circumferentia displacement of lateral meniscus in all fresh normal adult knee joint specimens including 10 specimens of complete ACL,5 of anteriomedialis bundle(AMB) rupture,5 of post-lateral bundle rupture(PLB) and 10 of complete rupture ACL are tested when the knee joints loaded 200N,400N,600Nand 800N at 0°, 30°,60°and 90°of flexion.
RESULT 1.The limit of circumferentia displacement of lateral meniscus is distributed between 0.5～2.7mm in complete ACL group.2. At 0°of flexion and under the loads of 200N,400N and 600N,the circumferentia displacement of lateral meniscus between ACL complete rupture group and PLB rupture group,complete ACL group and AMB rupture group shows no significant difference,P＞0.05;significant difference is displayed between complete ACL group and PLB rupture group,ACL complete rupture group and complete ACL group,AMB rupture group and PLB rupture group,P＜0.05;there is significant difference among each group under the load of 800N at 0°of flexion,P＜0.05.3.Under the loads of 200N and 400N,the circumferentia displacement of lateral meniscus between complete ACL group and PLB rupture group,ACL complete rupture group and AMB rupture group shows no significant difference at 30°and 60°of flexion,P＞0.05,and that among the other groups shows significant difference,P＜0.05;Under the loads of 600N and 800N,the circumferentia displacement among every group shows significant difference at 30°and 60°of flexion,P＜0.05.4.Under the loads of 200N,the circumferentia displacement of lateral meniscus between complete ACL group and PLB rupture group, ACL complete rupture group and AMB rupture group shows no significant difference at 90°of flexion,P＞0.05,and that among the other groups shows significant difference,P＜0.05;Under the loads of 200N,600N and 800N,the circumferentia displacement among every group shows significant difference at 90°of flexion,P＜0.05.
CONCLUSION 1.The physiological circumferentia displacement of lateral meniscus is between 0.5mm and 2.7mm.2.The circumferentia displacement of lateral meniscus in AMB rupture group at flexed position of the knee joint becomes bigger than that in complete ACL group.3.The circumferentia displacement of lateral meniscus in PLB rupture group at straight position of the knee joint becomes bigger than that in complete ACL group.4.The circumferentia displacement of lateral meniscus becomes big at all position of the knee joint when the ACL is ruptured completely.5.The abnormal circumferentia displacement of lateral meniscus after ACL rupture hints that ACL rupture maybe a factor which causes the degeneration of lateral meniscus.
第一章前交叉韧带断裂对外侧半月板生物力学特性的影响
目的探讨ACL断裂对外侧半月板生物力学的影响。
方法新鲜正常成人膝关节标本10具作为ACL完整组,在200N、400N、600N、800N载荷下,测试膝关节0°、30°、60°、90°位外侧半月板前角、体部和后角的应变,测试完毕后随机将标本造模成前内侧束(AMB)断裂组和后外侧束(PLB)断裂组,各5具,在上述条件下测试,最后再将10具标本的ACL完全切断进行测试。
结果1.膝关节0°位,在200N、400N载荷下,前角、体部、后角的应变在PLB切断组和ACL全断组、ACL完整组和AMB切断组之间无显著性差异,P＞0.05;在600N、800N载荷下各实验组之间有显著性差异,P＜0.05,前角和体部应变绝对值表现为全断组＞PLB切断组＞AMB切断组＞完整组,后角应变绝对值表现为全断组＜PLB切断组＜AMB切断组＜完整组。2.膝关节30°位,在200N、400N载荷下,前角、体部、后角的应变在ACL完整组和PLB切断组、AMB切断组和ACL全断组之间无显著性差异,P＞0.05;在600N、800N载荷下各实验组之间有显著性差异,P＜0.05,应变绝对值表现为全断组＞AMB切断组＞PLB切断组＞完整组。3.膝关节60°、90°位,相同载荷下各实验组应变之间有显著差异,P＜0.05,应变绝对值表现为全断组＞AMB切断组＞PLB切断组＞完整组。
结论1.ACL完全断裂,对外侧半月板前角、体部和后角的应变均有影响。2.在200N和400N载荷下,AMB切断在膝关节0°位和PLB切断在膝关节屈曲30°位对外侧半月板前角、体部和后角的应变均无影响。3.在600N和800N载荷下,AMB切断在膝关节0°位和PLB切断在屈膝30°、60°、90°位对外侧半月板前角、体部和后角的应变均有影响。4.在各实验载荷下,AMB切断在屈膝30°、60°、90°位和PLB切断在膝0°位对外侧半月板前角、体部和后角的应变均有影响。
第二章前交叉韧带断裂后外侧半月板退变的组织学研究
目的探讨ACL断裂对外侧半月板组织学的影响。
方法48只家兔膝关节配对为实验侧和对照侧,实验侧行ACL切断造模,造模后第1、3、6、8周各随机处死12只,行外侧半月板大体观察,并进行HE染色,免疫组化检测IL-1β、MMP13表达。
结果1.大体观察,随时间延长,实验组外侧半月板出现磨损,甚至撕裂,呈黄色,弹性差。2.组织学观察,随时间延长,半月板表面不平整,组织疏松,胶原纤维排列紊乱,炎性细胞浸润,间质水肿,软骨细胞变性减少。各实验组和对照组组织学退变评分均有显著性差异,P＜0.05。3.实验组IL-1β、MMP13表达均高于对照组,有显著性差异,P＜0.05。4.实验组IL-1β表达阳性率第3周高于第1周和第8周,有显著性差异,P＜0.05;实验组第6周高于第1周和第8周,有显著性差异,P＜0.05;实验组第8周IL-1β表达阳性率高于第1周,有显著性差异,P＜0.05;实验组第3周和第6周IL-1β表达阳性率无显著性差异,P＞0.05。6.实验组MMP13阳性表达率第3周高于第1周、第8周,均有显著性差异,P＜0.05;实验组MMP13阳性表达率第6周高于第8周和第1周,有显著性差异,P＜0.05;实验组MMP13阳性表达率第1周和第8周,有显著性差异,P＜0.05;实验组MMP13阳性表达率第3周和第6周无显著性差异,P＞0.05。
结论1.ACL断裂可引起外侧半月板组织退变。2.IL-1β、MMP13在ACL断裂膝关节外侧半月板中的表达呈先增高后降低的变化规律。3.IL-1β、MMP13表达增高提示IL-1β、MMP13可能是继发外侧半月板退变的因素之一。4.首次制定了半月板退变组织学评分标准。
第三章前交叉韧带断裂对外侧半月板周缘性移位影响的研究
目的探讨ACL断裂对外侧半月板周缘性移位的影响以及断裂程度与周缘性移位程度之间的关系。
方法新鲜正常成人膝关节标本10具作为ACL完整组,在200N、400N、600N、800N载荷下,测量膝关节0°、30°、60°、90°位外侧半月板周缘性位移,测量完毕后随机将标本造模成前内侧束(AMB)断裂组和后外侧束(PLB)断裂组,各5具,在上述条件下测量,最后再将10具标本的ACL完全切断作为全断组进行测量。
结果1.ACL完整时的外侧半月板移位分布在0.5～2.7mm。2.膝关节屈曲0°,在200N、400N、600N载荷下,全断组和PLB切断组、完整组和AMB切断组外侧半月板移位无显著性差异,P＞0.05;完整组和PLB切断组、全断组和完整组、AMB切断组和PLB切断组外侧半月板移位均有显著性差异,P＜0.05;在800N载荷下,各组外侧半月板移位均有显著性差异,P＜0.05。3.膝关节屈曲30°、60°,在200N、400N载荷下,完整组和PLB切断组、AMB切断组和全断组外侧半月板移位均无显著性差异,P＞0.05,其余各组间外侧半月板移位均有显著性差异,P＜0.05;在600N、800N载荷下各组间外侧半月板移位均有显著性差异,P＜0.05。4.膝关节屈曲90°,在200N载荷下,完整组和PLB切断组、AMB切断组和全断组外侧半月板移位均无显著性差异,P＞0.05,其余各组间外侧半月板移位均有显著性差异,P＜0.05;在400N、600N、800N载荷下各组间外侧半月板移位均有显著性差异,P＜0.05。
结论1.外侧半月板生理性移位范围为0.5～2.7mm。2.AMB断裂后外侧半月板在膝关节屈曲时移位明显增大。3.PLB断裂后外侧半月板在膝关节伸直时移位明显增大。4.ACL完全断裂后外侧半月板在膝关节屈曲、伸直时移位均明显增大。5.ACL损伤后外侧半月板移位明显,提示ACL损伤是外侧半月板退变的原因之一。
The anterior cruciate ligament(ACL) is a stable structure whose main role is controlling the antedisplacement of tibial and regulating the rotation of tibial as well as the varus and valgus of knee joint partly.The role of the lateral meniscus which is an important ingredient of the knee is shock absorption and stress transmission and stabilization of the knee joint.With the development of MRI and arthroscope,early diagnosis and treatment of ACL injury turns to be easily achieved,meanwhile,it is found that the secondary injury of ACL deficiency always occurs in articular cartilage,but it is little known whether deficiency of ACL effects on the lateral meniscus.In this study,straining changes in several sites of lateral meniscus caused by ACL injury is observed through biomechanics approach;histological changes of meniscus and expression of IL-1βand MMP13 in meniscus are observed so as to investigate the function of IL-1βand MMP13 in degeneration of lateral meniscus;circumferentia displacement of lateral meniscus after ACL injury is measured,so as to provide theoretical evidence whether deficiency of ACL effects on the lateral meniscus.
ChapterⅠThe Effect of ACL Rupture on the Biomechanics of Lateral Meniscus
OBJECTIVE The effect of ACL injury on all locations of lateral meniscus by measuring biomechanics is observed so as to explore the mechanism of lateral meniscus injury after ACL rupture.
METHOD The straining of lateral meniscus anterior horn, caudomedial part and posterior horn in all fresh normal adult knee joint specimens including 10 specimens of complete ACL,5 of anteriomedialis bundle(AMB) rupture,5 of post-lateral bundle rupture and 10 of complete rupture ACL are tested when the knee joints loaded 200N,400N,600N and 800N at 0°,30°,60°and 90°of flexion.
RESULT 1.The straining of lateral meniscus anterior horn, caudomedial part and posterior horn shows no significant difference between PLB rupture group and ACL complete rupture group,complete ACL group and AMB rupture group under the load of 200N and 400N at 0°of flexion,P＞0.05;significant difference is showed among all the groups under the loads of 600N and 800N at 0°of flexion,P＜0.05; under the same load and angle of flexion,the correlation of the absolute value of straining in every group of lateral meniscus anterior horn and caudomedial part increases in this way of ACL complete rupture group＞PLB rupture group＞AMB rupture group＞complete ACL group,and of posterior horn increases in this way of ACL complete rupture group＜PLB rupture group＜AMB rupture group＜complete ACL group. 2.The straining of lateral meniscus anterior horn,caudomedial part and posterior horn shows no significant difference between AMB rupture group and ACL complete rupture group,complete ACL group and PLB rupture group under the loads of 200N and 400N at 30°of flexion,P＞0.05;significant difference is showed among all the groups under the load of 600N and 800N at 30°of flexion,P＜0.05;under the same load and angle of flexion,the correlation of the absolute value of straining in every group increases in this way of ACL complete rupture group＞AMB rupture group＞PLB rupture group＞complete ACL group.3.There is significant difference among all the groups under the load of 200N,400N,600N and 800N at 60°and 90°of flexion,P＜0.05.under the same load and angle of flexion,the correlation of the absolute value of straining in every group increases in this way of ACL complete rupture group＞AMB rupture group＞PLB rupture group＞complete ACL group.
CONCLUSION 1.ACL complete rupture is likely to cause abnormal straining in all regions of lateral meniscus under different load and angle of flexion.2.Under the load of 200N and 400N,AMB rupture at 0°of flexion and PLB rupture at 30°of flexion cause no effect on the straining in all regions of lateral meniscus.3.Under the load of 600N and 800N,AMB rupture at 0°of flexion and PLB rupture at 30°,60°and 90°of flexion cause apparently effect on the straining in all regions of lateral meniscus.4.Abnormal straining in all regions of lateral meniscus can be caused by PLB rupture at 0°of flexion and AMB rupture at 30°,60°and 90°of flexion under different load.
ChapterⅡThe Research of Histology about Degeneration of Lateral Meniscus after Rupture of ACL
OBJECTIVE Study the effect on lateral meniscus which was caused by rupture of ACL.
METHOD Lateral meniscus of 48 rabbits matched mode pairs both in experiment side which ACL were transacted and control side,at the 1~(st),3~(rd),6~(th) and 8~(th) week,execute 12 rabbits randomly,then to observe lateral meniscus in general and through HE staining and immunohistochemistry staining,detect the expression of IL-1βand MMP13.
RESULT 1.The observation in general showed that along with the increase of the time lateral meniscus of experiment group gradually wore,even ruptured,presenting yellow and bad elasticity.2.Along with the increase of the time the observation of histology shows uneven surface of meniscus,loose tissue,disorder of collagen fibers,infiltration of inflammatory cell,interstitial edema and deformation of intracytoplasm mitochondrion in the chondrocytes.Histological evaluation of the degeneration in fibrocartilage of meniscus in both groups:The scores at the 1~(st),3~(rd),6~(th) and 8~(th) week were higher in the experimental group than those in the control group,showing significant difference,P＜0.05; the scores of experimental group at the 6~(th) and 8~(th) week was higher than that at the 1~(st) and 3~(rd) week,showing significant difference,P＜0.05,but there is no significant difference between the 1~(st) and 3~(rd) week,P＞0.05.3.At the 1~(st),3~(rd),6~(th)and 9~(th) week,expression of IL-1βand MMP13 is higher in experimental group than that in control group,showing significant difference,P＜0.05.4.In experimental group,expression of IL-1βis higher at the 3~(rd) than that at 1~(st) and 8~(th) week,showing significant difference,P＜0.05,expression of IL-1βis higher at the 6~(th) week than that at 1~(st) and 8~(th) week,showing significant difference,P＜0.05,expression of IL-1βis higher at the 8~(th) week than that at 1~(st) week,showing significant difference,P＜0.05,but there is no significant difference between the 3~(rd) and 6~(th) week.5.In experimental group, expression of MMP13 is higher at the 3~(rd) week than that at 1~(st) and 8~(th) week,showing significant difference,P＜0.05,expression of MMP13 is higher at the 6~(th) week than that at 1~(st) and 8th week,showing significant difference,P＜0.05,expression of MMP13 is higher at the 8~(th) week than that at 1~(st) week,showing significant difference,P＜0.05,but there is no significant difference between the 3~(rd) and 6~(th)week,P＞0.05.
CONCLUSION 1.Rupture of ACL could cause the degeneration of lateral meniscus.2.A regularity of expression of IL-1βand MMP13 is displayed that the expression is increasing in primal stage and decreasing in advanced stage after rupture of ACL 3.The high expression of IL-1βand MMP13 hints that IL-1βand MMP13 maybe a promotional factor which causes the degeneration of lateral meniscus.4.The histological evaluation criterion of degeneration of meniscus was made first time.
ChapterⅢThe Effect of ACL Rupture on the Circumferential Displacement of Lateral Meniscus
OBJECTIVE To explore the effect of ACL rupture on lateral meniscus circumferentia displacement and the correlation between the degree of ACL rupture and circumferentia displacement.
METHOD The circumferentia displacement of lateral meniscus in all fresh normal adult knee joint specimens including 10 specimens of complete ACL,5 of anteriomedialis bundle(AMB) rupture,5 of post-lateral bundle rupture(PLB) and 10 of complete rupture ACL are tested when the knee joints loaded 200N,400N,600Nand 800N at 0°, 30°,60°and 90°of flexion.
RESULT 1.The limit of circumferentia displacement of lateral meniscus is distributed between 0.5～2.7mm in complete ACL group.2. At 0°of flexion and under the loads of 200N,400N and 600N,the circumferentia displacement of lateral meniscus between ACL complete rupture group and PLB rupture group,complete ACL group and AMB rupture group shows no significant difference,P＞0.05;significant difference is displayed between complete ACL group and PLB rupture group,ACL complete rupture group and complete ACL group,AMB rupture group and PLB rupture group,P＜0.05;there is significant difference among each group under the load of 800N at 0°of flexion,P＜0.05.3.Under the loads of 200N and 400N,the circumferentia displacement of lateral meniscus between complete ACL group and PLB rupture group,ACL complete rupture group and AMB rupture group shows no significant difference at 30°and 60°of flexion,P＞0.05,and that among the other groups shows significant difference,P＜0.05;Under the loads of 600N and 800N,the circumferentia displacement among every group shows significant difference at 30°and 60°of flexion,P＜0.05.4.Under the loads of 200N,the circumferentia displacement of lateral meniscus between complete ACL group and PLB rupture group, ACL complete rupture group and AMB rupture group shows no significant difference at 90°of flexion,P＞0.05,and that among the other groups shows significant difference,P＜0.05;Under the loads of 200N,600N and 800N,the circumferentia displacement among every group shows significant difference at 90°of flexion,P＜0.05.
CONCLUSION 1.The physiological circumferentia displacement of lateral meniscus is between 0.5mm and 2.7mm.2.The circumferentia displacement of lateral meniscus in AMB rupture group at flexed position of the knee joint becomes bigger than that in complete ACL group.3.The circumferentia displacement of lateral meniscus in PLB rupture group at straight position of the knee joint becomes bigger than that in complete ACL group.4.The circumferentia displacement of lateral meniscus becomes big at all position of the knee joint when the ACL is ruptured completely.5.The abnormal circumferentia displacement of lateral meniscus after ACL rupture hints that ACL rupture maybe a factor which causes the degeneration of lateral meniscus.
引文
[1]Seedhom BB,Dowson D,Wright V.Proceedings:Function of the menisci,Apreliminary study.Ann Rheum Dis,1974,33:111.
[2]Chen E,Maffulli N,Chan KM.Knee injuries produced by recreational sports follow a different pattern than casual injuries.Bull Hosp Jt Dis,1998,57:74-9.
[3]王健全,敖英芳,刘平,等.前交叉韧带股骨止点临床解剖学研究.中国运动医学杂志,2007,26(3):266-70.
[4]Gabriel MT,Wong EK,Woo SL,et al.Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads.J Orthop Res,2004,22(1):85-9.
[5]Musahl V,Lehner A,Watanabe Y,et al..Biology and biomechanics.Current Opinion in Rheumatology,2002,14(2):127-133.
[6]张东龙,高顺生.膝关节半月板的形态学研究进展及其临床意义.北京体育师范学院学报,1999,11(2):79.
[7]Brindle T,Nyland J,Johnson DL.The meniscus:review of basic principles with application to surgery and rehabilitatio.J Athl Train,2001,36(2):160-9.
[8]皇甫小桥,赵金忠.半月板重建的临床研究进展.中华创伤骨科杂志,2006,8(6):570-3.
[9]Maquet PG,Van de Berg AJ,Simonet JC.Femorotibial weight-bearing areas,Experimental determination.J Bone Join tSurg AM,1975,57:766-71.
[10]Ahmed AM,Burke DL,Yu A.In-vitro measurement of static pressure distribution in synovial joints,Part Ⅱ:Retropatellar surface.J Biomech Eng,1983,105:226-36.
[11]Wickiewicz TL.Meniscal injuries in the crnciate-deficient knee.Clin Sports Med,1990,9:681-94.
[12]Henning CE.Current status of meniscus salvage.Clin Sports Med,1990,9:567-76.
[13]Bellabarba C,Bellabarba C,Bush-Joseph CA,et al.Patterns of meniscal injury in the anterior cruciate-deficient knee:a review of the literature.Am J Orthop,1997,26:18-23.
[14]黄加张,顾湘杰,潘哲尔,等.半月板突出在膝关节骨关节炎中地位的初步研究.中国临床医学,2004,11:1102-4.
[15]吴宏斌,张景辉.兔前交叉韧带切断骨关节炎模型中MMP-1 MMP-13及TIMP的mRNA的表达研究.中国风湿病学杂志,2002,6:169-72.
[16]汪爱媛,卢世璧,马志鹏,等.压敏片成像分析系统的研制及生物力学应用.北京生物医学工程,2001,20(4):282-4.
[17]Warner JJP,Bowen MK,Deng XH,et al.Articular contact patterns of the normal glenohumeraljoint.J Shoulder Elbow Surg,1998,7(4):381-8.
[18]Thambyah A,Goh JCH,Das De S.Contact stresses in the knee joint in deep flexion.Med Eng Phys,2005,27:329-35.
[19]肖东民,陈素芳,李雄等.前交叉韧带重建方法的生物力学研究.医学临床研究,2005,22(12):1667-70.
[20]郭磊,赵玉岩,范广宇.髋臼发育不良的三维光弹力学实验研究及其临床意义.中国医科大学学报,2002,31(6):464-5.
[21]张祚福,王万春.膝关节三维有限元分析.国际骨科学杂志,2006,27(2):43-5
[22]Donahue TLH,Hull ML,Rashid MM,et al.A finite element model of the human knee joint for the study of tibio-femoral contact.J Biomech Eng,2002,124(3):273-80.
[23]国家体育总局群体司.2000年国民体质监测报告.北京:北京体育大学出版社(第1版),2002:89-91.
[24] Greis PE, Bardana DD, Holmstrom MC, et al. Meniscal injury: Ⅰ Basic science and evaluation. J Am Acad Orthop Surg , 2002,10(3): 168-76.
[25] Greis PE, Holmstrom MC, Bardana DD, et al. Meniscal injury: Ⅱ Management. J Am Acad Orthop Surg , 2002, 10(3): 177-87.
[26] Englund M, Roos EM, Roos HP, et al. Patient-relevant outcomes, fourteen years after menisectomy: influence of type of meniscial tear and size of resection. Rheumatology (Oxford), 2001,40:631-9.
[27] Levy IM, Torzilli PA, Gould JD, et al. The effect of lateral meniscectomy on motion of the knee, J Bone Joint Surg Am, 1989, 71 : 401-6.
[28] Levy IM, Torzilli PA, Warren RF. The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Joint Surg Am, 1982,64:883-8.
[29] Naranje S, Mittal R, Nag H, et al. Arthroscopic and magnetic resonance imaging evaluation of meniscus lesions in the chronic anterior cruciate ligament-deficient knee. Arthroscopy, 2008, 24: 1045-51.
[30] Palmer I. On the injuries to the ligaments of the knee joint: a clinical study. Acta Chir Scand, 1938, 91: 1-282.
[31] Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res, 1975, (106): 216-31.
[32] Harner CD, Back GH, Vogrin TM, et al. Quantitative analysis of human cruciate ligament insertions. Arthroscopy, 1999, 15(7): 741-9.
[33] Mochizuki T, Muneta T, Nagase T, et al. Cadaveric knee observation study for describing anatomic femoral tunnel placement for two-bundle anterior cruciate ligament reconstruction. Arthroseopy, 2006, 22(4): 356-61.
[34] Amis AA, Dawkins GP. Functional anatomy of the anterior cruciate ligament, Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br, 1991, 73(2): 260-7.
[35]Norwood LA,Cross MJ.Anterior cruciate ligament:functional anatomy of its bundles in rotatory instabilities.Am J Sports Med,1979,7(1):23-6.
[36]Takahashi M,Doi M,Abe M,et al.Anatomical study of the femoral and tibial insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament.Am J Sports Med,2006,34(5):787-92.
[37]Odensten M,Gillquist J.Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction.J Bone Joint Surg,1985,67A:257-62.
[38]Hirokawa S,Yamamoto K,Kawada T.Circumferential measurement and anslysis of strain distribution in the human ACL using a photoelastic coating method.J Biomech,2001,34:1135-43.
[39]张文强,王成琪,唐胜建,等.单束单隧道与双束双隧道重建膝前交叉韧带的生物力学对比研究,中国矫形外科杂志,2006,14(10):757-9.
[40]Getelman MH,Friedman MJ.Revision anterior cruciate ligament reconstruct -ion surgery.J Am Acad Orthop Surg,1999,7:189-98.
[41]Vergis A,Gillquist J.Gratf failure in intra-articular ACL reconstructions:a review of the literature.Arthroscopy,1995,11:312-21.
[42]Hogervorst T,Rijcken THP,Rucker D,et al.Changes in bone scans after anterior cruciate ligament reconstruction:A prospective study.Am J Sports Med,2002,30:823-33.
[43]Frank CB,Jackson DW.Current concepts review:The science of reconstruction of the anterior cruciate ligament.J Bone Joint Surg AM,1997,79:1556-76.
[44]Papageorgiou CD,Gil JE,Kanamori A,et al.The biomechanical interdependence between the anterior cruciate ligament replacement graft and the medial meniscus.Am J Sports Med,2001,29:226-31.
[45]Takeuchi R,Saito T,Mituhashi S,et al.Double-bundle anatomic anterior cruciate ligament reconstruction using bone-hamstring-bone composite graft. Arthrocopy,2002,18:550-5.
[46]Yagi M,Wong EK,Kananmori A,et al.Biomechanical analysis of an anatomic ACL reconstruction.Am J Sports Med,2002,30:660-7.
[47]Maffulli N,Binfield PM,King JB.Articular cartilage lesions in the symptomatic anterior cruciate ligament-deficient knee.Arthroscopy,2003,19:685-90.
[48]Ichinohe S,Yoshida M,Murakami H,et al.Meniscal tearing after ACL reconstruction.J Orthop Surg,2000,8:53-9.
[49]Tayton E,Verma R,Higgins B,et al.A correlation of time with meniscal tears in anterior cruciate ligament deficiency:stratifying the risk of surgical delay.Arthroscopy,2009,17(1):30-4.
[50]Lohmander LS,Englund PM,Dahl LL,et al.The long-term consequence of anterior cruciate ligament and meniscus injuries:osteoarthritis.Am J Sports Med,2007,35(10):1756-69.
[51]Murrell GA,Maddali S,,Horovitz L,et al.The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss.Am J Sports Med,2001,29(1):9-14.
[52]McDermott ID,Masouros SD,Amis AA.Biomechanics of the menisci of the knee.Current Orthop,2008,22(3):193-201.
[1]Englund M,Roos EM,Roos HP,et al.Patient-relevant outcomes fourteen years after menisectomy:influence of type of meniscial tear and size of resection.Rheumatology(Oxford),2001,40:631-9.
[2]贺石林,李元建.医学科研方法学.人民军医出版社,第1版,2001:229-32.
[3]李瑞锡,李静.家兔膝关节半月板的形态观察及图象测量.云南师范大学学报:自然科学版,1992,12:74-8.
[4]Muir H.The chondrocyte,architect of cartilage,Biomechanics,structure,function and molecular biology of cartilage matrix macromolecules.Bioessays,1995,17(12):1039-48.
[5]陈百成,张静.骨关节炎.北京:人民卫生出版社,2004.154-77.
[6]吴宏斌,杜靖远,胡勇,等.兔前交叉韧带切断骨关节炎模型中MMP-1MMP-13及TIMP-1的mRNA表达研究.中华风湿病学杂志,2002,6(3):169-72.
[7]Petersen W,Tillmann B.Collagenous fibral texture of the human knee joint menisci.AnatEmbryol(Berl),1998,197:317-24.
[8]Tanaka T,Fujii K,Kumagae Y.Comparation of biochemical characteristics of cultured fibrochondrocytes isolated from the inner and outer regions of human meniscius.Knee Surg Sports Traumatol Arthrosc,1999,7:75-80.
[9]Kobayashi M,Squires GR,Mousa A,et al.Role of interleukin-1 and tumor necrosis factor alpha in matrix degradation of human osteoarthritic cartelage.Arthritis Rheum,2005,52:128-35.
[10]Pelletier JP,McCollum R,Cloutier JM,et al.Synthesis of metalloproteases and interleukin 6(IL-6) in human osteoarthritic synovial membrane is an IL-1 mediated process.J Rheumatol Suppl,1995,43:109-14.
[11]Fell HB,Jubb RW.The effect of synovial tissue on the breakdown of articular cartilage in organ culture.Arthritis Rheum,1977,20:1359-71.
[12]Schwab W,Schlze-Tanzil G,Mobasheri A,et al.Interleukin-lbeta-induced expression of the urokinase-type plasminogen activator receptor and its co-localization with MMPs in human articular chondrocytes.Histol Histopathol,2004,19:105-12.
[13]Blanco FJ,Lotz M.IL-1-induced nitric oxide inhibits chondrocyte proliferation via proteoglycane E2.Exp Cell Res,1995,218:319-25.
[14]Iannone F,Lapadula G.The pathophysiology of osteoarthritis.Aging Clin and Exp Res,2003,15:364-72.
[15]Arner EC,Tortorella MD.Signal transduction through chondrocyte integrin receptors induces matrix metalloproteinase synthesis and synergizes with interleukin-1.Arthritis Rheum,1995,38:1304-14.
[16]Fernandes JC,Martel-Pelletier J,Pelletier JP.The role of cytokines in osteoarthritis pathophysiology.Biorheology,2002,39:237-46.
[17]Dayer JM.The saga of the discovery of IL-1 and TNF and their specific inhibitors in the pathogenesis and treatment of rheumatoid arthritis.Joint Bone Spine,2002,69:123-32.
[18]Vuolteenaho K,Moilanen T,Hamalainen M,et al.Regulation of nitric oxide production in osteoarthritic and rheumatoid cartilage-Role of endogenous IL-1 inhibitors.Scand J Rheumatol,2003,32:19-24.
[19]Murakami S,Lefebvre V,de Crombrugghe B.Potent inhibition of the master chondrogenic factor Sox9 gene by interleukin-1 and tumor necrosis factor-alpha.J Biol Chem,2000,275(5):3687-92.
[20]Heraud F,Heraud A,Harmand MF.Apoptosis in normal and osteoarthritic human articular cartilage.Ann Rheum Dis,2000,59(12):959-65.
[21]陈延文,王艾林,周建平,等.关节软骨细胞凋亡.中国医学科学院学报,2000,22(4):364-5.
[22]Vuolteenaho K,Moilanen T,Knowles RG,et al.The role of nitric oxide in osteoarthritis.Scand J Rheumatol,2007,36:247-51.
[23]Pelletier JP,Faure MP,Dibattista JA,et al.Coordinate synthesis of stromelysin interleukin-1 and oncogene proteins in experimental osteoarthritis:An immunohistochemical study.Am J Pathol,1993,142:95-105.
[24]Joos H,Albrecht WG,Laufer S,et al.IL-1 beta regulates FHL-2 and other cytoskeleton-related genes in human chondrocytes.Molecular Medicine,2008,14:150-9.
[25]Cawston TE,Billington C.Metalloproteinases in the rheumatic diseases.J Pathol,1996,180(2):115-7.
[26]刘智敏,周总光.基质金属蛋白酶的结构-功能和调节.生物医学工程学杂志,2002,19(4):680-3.
[27]Nagase H,Woessner JF.Matrix metalloproteinases.J Biol Chem,1999,274(31):21491-4.
[28]Gomez DE,Alonso DF,Yoshiji H,et al.Tissue inhibitors of metalloproteinases:structure,regulation and biological functions.Eur J Cell Biol,1997,74(2):111-22.
[29]Ishiguro N,Ito T,Oguchi T,et al.Relationships of matrix metalloproteinases and their inhibitors to cartilage proteoglycan and collagen turnover and inflammation as revealed by analyses of synovial fluids from patients with rheumatoid arthritis.Arthritis Rheum,2001,44(11):2503-11.
[30]Ogata Y,Miura K,Ohkita A,et al.Imbalance between matrix metalloproteinase 9 and tissue inhibitor of metalloproteinases 1 expression by tumor cells implicated in liver metastasis from colorectal carcinoma.Kurume Med J,2001,48(3):211-8.
[31]Close DR.Matrix metalloproteinase inhibitors in rheumatic diseases.Ann Rheum Dis,2001,60(Suppl 3):62-7.
[32]Lafleur MA,Hollenberg MD,Atkinson SJ,et al.Activation of pro-(matrix metalloproteinase-2)(pro-MMP-2) by thrombin is membrane-type-MMP -dependent in human umbilical vein endothelial cells and generates a distinct 63 kDa active species.Biochem J,2001,357(Pt 1):107-15.
[33]Murphy G,Stanton H,Cowell S,et al.Mechanisms for pro matrix metalloproteinase activation.APMIS,1999,107(1):38-44.
[34]Buckwalter JA,Martin JA.Osteoarthritis.Adv Drug Deliv Rev,2006,58(2):150.
[35]姚如愚,张晓.基质金属蛋白酶与骨关节炎.国外医学内科学分册,2001,28(4):159-62.
[36]Sanchez C,Deberg MA,Piccardi N,et al.Osteoblasts from the scleraotic subchondral bone downregulate aggrecan but upregulate metalloproteinases expression by chondrocytes,This effect is mimicked by interleukin-6,-1beta and oncostatin M pre-treated nonsclerotic osteoblasts.Osteoarthritis Cartilag -e,2005,13(11):979.
[37]Legendre F,Bogdanowicz P,Boumediene K,et al.Role of interleukin 6(IL-6)/(IL-6R)-induced signal tranducers and activators of transcription and mitogen activated protein kinase/extracellular.J Rheumatol,2005,32(7):1307.
[38]郭静,张娜,闫冰,等.MMP-13与IL-6在骨性关节炎相关性表达的研究.华北煤炭医学院学报,2008,10(3):297-9.
[39]亓建洪,赵庆华,刘延菊,等.白细胞介素-1 β对人软骨细胞基质金属蛋白酶-13mRNA表达的作用,中华风湿病学杂志,2005,9(3):138-41.
[40]Aida Y,Maeno M,Suzuki N,et al.The effect of IL-1 beta on the expression of matrix metalloproteinases and tissue inhibitor of matrix metalloproteinases in human chondrocytes.Life Sci,2005,77(25):3210-21.
[41]Hellio Le,Graverand MP,Eggerer J,et al.Matrix metalloproteinase-13expression in rabbit knee joint connective tissues:influence of maturation and response to injury,Matrix Biol 2000,19:431-41.
[42]Fernandes JC,Martel-Pelletier J,Lascau-Coman V,et al.Collagenase-1 and collagenase-3 synthesis in normal and early experimental osteoarthritic cani -ne cartilage:Animmunohistochemical study,Rheumatol,1998,25:1585-94
[43]Bluteau G,Conrozier T,Mathieu P,et al.Matrix metalloproteinase-1,-3,-13 and aggrecanase-1 and-2 are differentially expressed in experimental osteoarthritis.Biochim Biophys Acta,2001,1526:147-58.
[44]Oh H,Yang S,Park M,et al.Matrix Metalloproteinase(MMP)-12Regulates MMP-9 Expression in Interleukin-1-Treated Articular chondrocytes,J Cellular Biochemistry,2008,105(6):1443-50.
[45]Hashimoto S,Ochs RL,Komiya S,et al.Linkage of chondrocyte apoptosis and cartilage degradation in human osteoarthritis,Arthritis Rheumm,1998,41:1632-8.
[46]Murrell GA,Maddali S,Horovitz L,et al.The effect of time course after anterior cruciate ligament injury in correlateion with meniscal and cartilage loss.AM J Sports Med,2001,29:9-14.
[47]Deschner J,Rath-Deschner B,Agarwal S.Regulation of matrix metalloproteinase expression by dynamic tensile strain in rat fibrochondrocytes.OsteoArthritis and Cartilage,2006,14:264-72.
[48]薛海滨,敖英芳,于长隆,等.前交叉韧带断裂和重建对膝关节软骨退变影响的实验研究,中华外科杂志,2002,40(4):304-7.
[49]管剑龙,施桂英.基质金属蛋白酶与骨关节炎.中华风湿病学杂志,2000,4:54-6.
[1]Kocher MS,Klingele K,Rassman SO.Meniscal disorders:normal discoid and cysts.Orthop Clin North Am,2003,34(3):329-40.
[2]Greis PE,Bardana DD,Holmstrom MC,et al.Meniscal injury:Ⅰ.Basic science and evaluation.J Am Acad Orthop Surg,2002,10(3):168-76.
[3]Greis PE,Holmstrom MC,Bardana DD,et al.Meniscal injury:ⅡManagement.J Am Acad Orthop Surg,2002,10(3):177-87.
[4]吴海山,徐青雷.膝半月板外科与组织工程学重建.第二军医大学出版社,第1版,1999:3-8.
[5]Vedi V,Williams A,Tennant SJ,et al.Meniscal movement:An in-vivo study using dynamoic MRI.J Bone Joint Surg Br,1999,81:37-41.
[6]Thompson WO,Thaete FL,Fu FH,et al.Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images.Am J sports Med,1991,19(3):210-15.
[7]Bylski-Austrow DI,Ciarelli MJ,Kayner DC,et al.Displacements of the mencici under joint load:an vitro study in human knees.J Biomech,1994,27:421-31.
[8]Pagnani MJ,Cooper DE,Warren RF.Extrusion of the medial meniscus.Arthroscopy,1991,7(3):297-300.
[9]Englund M,Roos EM,Roos HP,et al.Patient-relevant outcomes fourteen years after meniscectomy:influence of type of meniscal tear and size of resection.Rheumatology(Oxford)A2001,40(6):631-9.
[10]Renstrom]B,Johnson RJ.Unatomy and biomechanics of the menisci.Clin sports Med,1990,9:523-38.
[11]Qreitenseher MJ,Rrattnig S,Dobrocky I,et al.MR imaging of meniscal subluxation in the knee.Acta Radiol,1997,38:876-9.
[12]George M,Wall FJ.Locked knee caused by meniscal subluxation MR imaging and arthroscopic verification.Arthroscopy,2003,19:885-8.
[13]Kenny C.Radial displacement of the medial meniscus and Fairbank's signs.Clin Orthop Relat Res,1997,(339):163-73.
[14]Miller TT,Staron RB,Feldman F,et al.Meniscal position on routine MR imaging of the knee.Okeletal Radiol,1997,26:424-7.
[15]Smith FB,Blair HC.Tibial collaterall ligament strain due to occult derangements of the medial meniscus:conformed by operation in thirty case.J Bone Joint Surg Am,1954,36-A:88-93;passim.
[16]陈坚,吕厚山,劳山,等.膝关节半月板周围性移位现象及其临床意义.中华骨科杂志,2005,(25)7:426-9.
[17]Breitenseher MJ,TrattnigS,Dobrocky I,et al.MR imaging of meniscal subluxation in the knee.Acta Radiol,1997,38:876-9.
[18]Sugita T,Kawamata T,Ohnuma M,et al.Radial displacement of the medial meniscus in varus osteoarthritis of the knee.Clin Orthop Relat Res,2001,8:171-7.
[19]王希强,刘世恩,郭永存,等.膝关节半月板损伤 MRI 分级与半月板半脱位的相关性分析.中国临床医学影像杂志,2007,18:657-60.
[20]陈坚,吕厚山,劳山,等.膝关节半月板周围性移位现象的初步 MRI 研究.中华放射学杂志,2006,40:612-5.
[21]Renstrom P,Johnson RJ.Anatomy and biomechanics of the menisci.Clin Sports Med,1990,9:523-38.
[22]黄竟敏,王植,赵力,等.半月板损伤的 MRI 诊断与关节镜所见的比较研究.中华骨科杂志,2003,23:403-7.
[23]Naredo E,Cabero F,Palop MJ,et al.Ultrasonographic findings in knee osteoarthritis:a comparative study with clinical and radiogramphic assessment.Osteoarthritis and Cartilage,2005,13(7):568-74.
[24]Ko CH,Chan KK,Peng HL.Sonographic imaging of meniscal subluxation in patients with radiographic knee osteoarthritis.Journal of the Formosan Medical Association,2007,106(9):700-7.
[25]Verdonk P,Depaepe Y,Desmyter S,et al.Normal and transplanted lateral knee menisci:evaluation of extrusion using magnetic resonance imaging and ultrasound.Knee Surgery Sports Traumatology Arthroscopy,2004,12(5):411-9.
[26]Tienen TG,Buma P,Scholten JGF,et al.Displacement of the medial meniscus within the passive motion characteristics of the human knee joint:an RSA study in human cadaver knees.Knee Surg Sports Traumatol Arthrosc,2005,13(4):287-92.
[27]Boxheimer L,Lutz M,Treiber K,et al.MRI of the knee:position related changes of the menisci in asympotamtic volunteers.Invest Radiol,2004,39:254-63.
[28]Ikeuchi K,Sakoda H,Sakaue R,et al.A new method for accurate measurement of displaycement of the knee menisci.Pro Inst Mech Eng,1998,212(3):183-8.
[29]黄加张,顾湘杰,潘哲尔,等.半月板突出在膝关节骨关节炎中地位的初步研究.中国临床医学,2004,11:1102-4.
[30]周自明,丁永生,田芳,等.膝关节半月板周缘脱位征象的 MRI 研究及其临床意义初探.医学影像杂志,2008,18(9):1055-8.
[31]蒋欣,李箭,裴福兴,等.人体正常半月板的大体解剖学测量与半月板重建的关系.四川医学,2002,23:795-6.
[32]Costa RC,Morrison WB.Medial meniscus extrusion on knee MRI:is extent associated with severity of degeneration or type of tear ? AJR,2004,183:7-23.
[33]范宏斌,张春礼,李明全,等.前交叉韧带断裂后半月板和软骨损伤的临床研究.中华创伤杂志,2004,20:73-6.
[34]Marzo Jm,Gurske-Deperio J.Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications.Am J Sports Med,2009,37(1):124-9.
[1]Clark CR,Ogden JA.Development of the Meniscus of the Human Knee Joint.J Bone Joint Surg Am,1983,65:538-47.
[2]Brindle T,Nyland J,Johnson DL.The meniscus:review of basic principles with application to surgery and rehabilitation.J Athl Train,2001,36(2):160-9.
[3]Arnoczky SP,Warren RF.Microvaculature of the human meniscus.AM J Spots Med,1982,10:90-5.
[4]Radin EL,Delamotte F,Maquet P.Role of the menisci in the distribution of stresss in the knee.Clin Orthop,1984,185:290-4.
[5]Baratz ME,Mengator R.Meniscal tears:The effect of meniscectomy and repair on intra-articular contact areas and stress in the human knee.Am J Sports Med,1986,14:270-5.
[6]Ahmed AM,Burke DL.In vitro measurement of static pressure distribution in synovial joints Part-Ⅰ Tibial surface of the knee,J Biomech Eng,1983,105:216-25.
[7]Levy IM,Torzdli PA,Warrent RF.The effect of medial meniscetomy on anterior-posterior motion of the knee.Bone Joint Surg Am 1982,84: 883-8.
[8]马楚平,梁江山,何光联,等.半月板损伤关节镜下的处理.实用骨科杂志,2007,3:139-41.
[9]张文涛,黄英,卢世璧.3种下蹲试验对半月板损伤的诊断意义.实用骨科杂志,2006,6:511-3.
[10]赵汉平,孙磊,李佩佳,等.临床检查对半月板损伤的价值.中国矫形外科杂志,2002,6:643-5.
[11]戴刚,张卫东,王东武,等.关节镜下手术治疗膝半月板损伤478例流行病学调查分析.重庆医学,2006,13:1168-70.
[12]王亦璁.创伤早期处理.北京:人民卫生出版社,1994:122-5.
[13]杨君礼,史振满,许刚,等.改良蹲走试验在诊断膝关节半月板损伤中的临床意义.骨与关节损伤杂志2003,18(7)447-8.
[14]田野,白伦浩,付勤.麦氏试验对半月板损伤和膝关节间隙内疾病的诊断价值比较.中国骨伤,2007,20(11):736-8.
[15]Karachalios T,Hantes M,Zibis AH,et al.Diagnostic accuracy of a new clinical test(the Thessaly test)for early detection of meniscal tears.J Bone Joint Surg(Am),2005,87(5):955-62.
[16]赵汉平,孙磊,李佩佳,等.临床检查对半月板损伤的价值.中国矫形外科杂志,2002,6:643-45.
[17]吴清君.40例膝关节绞锁的关节镜所见分析.中医正骨,2006,1049-50.
[18]万斌,吕天润,吕征.103例老年患者内侧半月板后角损伤的治疗.南京医科大学学报,2007,1:89-90.
[19]燕树义,高晓荣,李学民,等.中老年人半月板损伤的关节镜诊断治疗.中国修复重建外科杂志,6:623-6.
[20]冯瑛琦,徐斌,徐洪港,等.膝关节弹响的发生和关节镜诊治.安徽医科大学学报,2006,1:94-6.
[21]于利,王立德,吕德成,等.膝关节伸直受限的关节镜下治疗.中华外科杂志,2006,44(12):833-5.
[22]胥少汀,葛宝丰,徐印坎,等.实用骨科学(第3版).北京:人民军医出版社,2005.1844.
[23]白卫东,娄思权.半月板损伤几种诊断方法的评价:物理诊断、关节造影、B超、MRI与关节镜诊断比较.骨与关节损伤杂志,1995,10:1-7.
[24]Duras JM.Meniscal abnormalities:prospective correlation of double contrast arthrography and arthroscopy.Ridiography,1986,160:453.
[25]Kimorl K.Evaluation of arthrography and arthroscopy for lesions of the posteromedical comer of the knee.Am J Sports Med,1989,17(5):638.
[26]Feller JA,Webster KE.Clinical value of magnetic resonance imaging of the knee.ANI Surg,2001,71(9):531-7.
[27]陈海南,董启榕,汪益,等.低场强磁共振成像诊断半月板撕裂的准确性研究.中华创伤杂志,2004,2:83-4.
[28]Vincken PW,Braak BP,ven Erkell AR,et al.Effectiveness of MR imaging in selection of patients for arthroscopy of the knee.Radiology,2002,223:739-46.
[29]Magee T,Williams D.3.0-T MRI ofmeniscal tears.AJR,2006,8:371-5.
[30]De Smet AA,Tuite MJ.Use of the"two-slice-touch"rule for the MKI diagnosis of meniscal tears.AJR Am J Roentgenol,2006,4:911-4.
[31]Thomas S,Pullagura M,Robinson E,et al.The value of magnetic resonance imaging in our current management of ACL and meniscal injuris.Knee Surg Sports Traumatol Arth,2007,5:533-6.
[32]Friedl W,Glaser F.Dynamic sonography in the diagnosis of ligament and meniscal injuries of the kne.Arch Orthop Trauma Surg,1991,110:132.
[33]齐晓东,王荣,黄洁红.半月板损伤的MRI诊断及临床价值.浙江临床医学,2006,(8)7:767.
[34]王韶进,戴国锋,刘琦.B超在半月板损伤中的诊断价值.山东医科大学学报,2001,39(6):542-3.
[35]施林枫,胡新娥,宋鲁梅,等.B超对膝关节半月板损伤的诊断价值.浙江临床医学,2007,9(11):1555.
[36]尹东,孙可,满育平,等.膝半月板损伤的临床、MRI及关节镜对比研究.中国矫形外科杂志,2007,15(24):1872-4.
[37]Ryzewicz M,Peterson B,Siparsky PN,et al.The diagnosis of meniscus tears:the role of MRI and clinical examination.Clin Orthop,2007,455:123-33.
[38]McCarty EC,Marx RG,DeHaven KE.Meniscus repair:Considerations in treatment and update of clinical results.Clin Orthop,2002,402:122-34.
[39]Morrissey MC,Goodwin PC.Correlates of knee extensor training load used in rehabilitation after knee surgery.J Strength Cond Res,2007,21(4):1050-2.
[40]戴刚,张卫东,王东武,等.关节镜下手术治疗膝半月板损伤478例流行病学调查分析.重庆医学,2006,13:1168-70.
[41]van Tienen TG,Heijkants RG,de Groot JH,et al.Presence and mechanism of knee articular cartilage degeneration after meniscal reconstruction in dogs.Osteoarthritis Cartilage,2003,11(1):78-84.
[42]Kamei G,Sumen Y,Sakuridani K.Evaluation of cartilage defect at medial femoral condyle in early osteoarthritis of the knee.J Chugoku Shikoku Orthop Association,2006,18(2):229-33.
[43]Felix NA,Paulos LE.Current status of meniscal transplantation.Knee,2003,10(1):13-7.
[44] Heckmann TP, Barber-Westin SD, Noyes FR. Meniscal repair and transplantation: Indications, techniques, rehabilitation, and clinical outcome. J Orthop Sports PHYs Then 2006, 36(10): 795-814.
[45] Barber FA, McGarry JE. Meniscal repair techniques. Sports Med Arthrosc, 2007, 15 (4): 199-207.
[46] Steenbrugge F, Verdonk R, Verstraete K. Long-term assessment of arthroscopic meniscus repair: a 13-year follow-up study. Knee, 2002, 9: 181-7.
[47] Lohmander LS, Englund PM, Dahl LL, et al. The long-term consequence of anterior cruciate ligament and meniscus injuries. Osteoarthritis Am J Sports Med, 2007, 35(10): 1756-69.
[48] KimuraM, ShirakuraK, Hasegawa A, et al. Second look arthroscopy after meniscal repair. Factors affecting the healing rate. Clin Orthop Relat Res, 1995, (314): 185-91.
[49] Swenson TM. The use of exogenous fibrin clot to supplement meniscal surgery techniques. Orthopedics, 2007, 30(9): 718-23.
[50] Rodeo SA. Menical allografts-where do we stand?Am J Sports Med , 2001, 29(2): 246-61.
[51] Verdonk R, Almqvist KF, Huysse W, et al. Meniscal allografts: Indications and outcomes. Sports Med Arthrosc, 2007, 15(3): 121-5.
[52] KohnD, Wirth CJ, Reiss G, et al. Medial meniscus replacement by a tendon autograft experiments in sheep, J Bone Joint Surg Br, 1992,74(6): 910-12.
[53] Mora G, Alvarez E, Ripalda P, et al. Articular cartilage degeneration after frozen meniscus and Achilles tendon allograft transplantation: Experimental study in sheep. Arthroscopy, 2003, 19(8): 833-41.
[54] Johnson LL, Feagin JA. Autogenous tendon graft substitution for absent knee joint meniscus:A pilot study.Arthroscopy,2000,16(2):191-6.
[55]Shaffer B,Kennedy S,Klimkiewicz J,et al.Preoperative sizing of meniscal allografts in meniscus transplantation.Am J Sports Med,2000,28(4):524-33.
[56]Fox MG.MR imaging of the meniscus:Review,current trends,and clinical implications.Radiologic Clinics of North America,2007,45(6):1033-53.
[57]Crawford R,Walley G,Bridgman S,et al.Magnetic resonance imag -ing versus arthroscopy in the diagnosis of knee pathology,concentrating on meniscal lesions and ACL tears:a systematic review.Br Med Bull,2007,84:5-23.
[58]Wirth CJ,Peters G,Milachowski KA,et al.Long-term results of meniscal allograff transplantation.AMJ Sports Med,2002,30(2):174-81.
[59]VerdonkR.Meniscal transplantation.Acta Orthop Belg,2002,68:118-27.
[60]Kurzweil PR,Friedman MJ.Meniscus:Resection,repair and replace -ment.Arthroscopy,2002,18:33-9.
[61]Stollsteimer GT,Shelton WR,Dukes A,et al.Meniscal allograff transpl -antation:a 1 to 5-year follow-up of 22 patients.Arthroscopy,2000,16(4):343-7.
[62]van Arkel ER,de Boer HH.Survival analysis of human meniscal transplantation.J Bone Joint Surg Br,2002,84(2):227-31.
[63]Verdonk PCM,DemurieA,Almqvist F,et al.Transplantation of viable meniscal allograft:Survivor ship analysis and clinical outcome of one hundred cases.J Bone Joint Surg Am,2005,87(4):715-24.
[64]Matava MJ.Meniscal allograff transplantation:a systematic review.Clin Orthop,2007,455:142-57.
[65]余家阔,谢兴,张继英,等.异种异体和同种异体半月板移植修复兔 膝关节半月板缺失的预后研究.中国运动医学杂志,2004, 6： 604-8.
[66] Welch JA, Montgomery RD, Lenz SD, et al. Evaluation of small- -intestinal submucosa implants for repair of meniscal defects in dogs. J Vet Res(Am), 2002, 3: 427-31.
[67] Cook JL, Fox DB, Malaviya P, et al. Long-term outcome for large meniscal defects treated with small intestinal submucosa in a dog model. J Sports Med(Am), 2006, 34: 32-42.
[68] Messner K, Gillquist J. Prosthetic replacement of the rabbit medial meniscus. J Biomed Mater Res, 1993, 27: 1165-73.
[69] Messner K. The concept of a permanent synthetic meniscus prosthesis: a critical discussion after 5 years of experimental investigations using Dacron and Teflon implants. Biomaterials, 1994, 15: 243-50.
[70] Kobayashi M. A study of polyvinyl alcohol-hydrogel(PVA-H) artifcial meniscus in vivo. Biomed Mater Eng, 2004, 14: 505-15.
[71] Kobayashi M, Toguehida J, Oka M. Development of an artificial meniscus using polyvinyl alcohol-hydrogel for early return to, and continuance of, athletic life in sport spersons with severe meniscus injury. Knee, 2003, 10: 53.
[72] Hoben GM, Athanasiou KA. Meniscal repair with fibrocartilage engineering. Sports Med Arthrosc, 2006, 14(3): 129-37.
[73] Caplan AL. Adult mesenchymal stem cells for tissue engineering versus regenerative medicine. J Cell Physiol, 2007, 213(2):341-7.
[74] Dietmar WH. Scafolds in tissue engineering bone and cartilage. J Biomater, 2000, 21:2529-43.
[75] Kobayashi M. A study of polyvinyl alcohol-hydrogel artificial meniscius in vivo. Biomed Mater Eng, 2004, 14(4): 505-15.
[76] Stone KR, SteadmanJR, RodkeyWG, et al. Regeneration of meniscal cartilage with use of a collagen scaffold:Analysis of preliminary data.J Bone Joint Surg Am,1997,79(12):1770-7.
[77]Marijnissen WJ,Van Osch GJ,Aigner J,et al.Alginate as a chondrocyte -delivery substance in combination with a non-woven scaffold for cartilage tisue engineering.Biomaterials,2002,23(6):1511-7.
[78]Reguzzoni M,Manelli A,Ronge M,et al.Histology and ultrastructure of a tisue-engineered collagen meniscus before and after implantation.J Biomed Mater Res B ApplBiomater,2005,74B(2):808-16.
[79]叶川,邓展生,申定珠,等.外消旋聚丙交酯与人胚半月板细胞构建复合物的研究.贵阳医学院学报,2007,32(6):591-3.
[80]刘和风,王俊飞,黄际河,等.丝素-胶原复合物半月板支架负载纤维软骨细胞的实验观察.山东医药,2008,48(15):27-8.
[81]Bodin A,Concaro S,Brittberg M,et al.Bacterial cellulose as a potential meniscus implant.J Tissue Eng Regen Med,2007,1(5):406-8.
[82]Hennerbichler A,Moutos FT,Hennerbichler D,et al.Interleukin-1 and tumor necrosis factor alpha inhibit repair of the porcine meniscus in vitro.OsteoarthritisCartilage,2007,15(9):1053-61.
[83]Ivkovic A,Pascher A,Hudetz D,et al.Current concepts in gene therapy of the musculoskeletal system,Acta Chit Orthop Traumatol Cech,2006,73(2):115-22.
[84]Nakata K,Shino K,Hamada M,et al.Human meniscus cell:Characterization of the primary culture and use for tissue engineering.Clin Orthop Relat Res,2001,391:208-18.
[85]Zaleskas JM,Kinner B,Frcyman TM,et al.Growth factor regulation of smoth muscle actin expression and contraction of human articular chondrocytes and meniscal cells in a collagen-GAG matrix.Exp Cell Res,2001,270(1):21-31.
[86] Pangborn CA, Athanasiou KA. Effects of growthfactors on meniscal fibrechondrocytes. Tissue Eng, 2005, 11: 1141-8.
[87] Hidaka C, Ibarra C, Hannafm JA, et al. Formation of vascularized meniscal tissue by combining gene therapy with tissue engineering. Tissue Eng, 2002, 8(1): 93-105.
[88] Bhargava MM, Hidaka C, Hannafm JA, et al. Effects of hepatocyte growth factor and platelet-derived growth factor on the repair of meniscal defects in vitro. In Vitro Cell Dev Biol Anim, 2005, 41: 305-10.
[89] IshidaK, KurodaR, MiwaM, et al. The regenerative effects of platelet rich plasma on meniscal cells in vitro and its in vivo application with biodegradable gelatin hydrogel. Tissue Eng, 2007, 13(5): 1103-12.
[90] Goto H , Shuler FD, Lamsam C, et al. Transfer of lacZ marker gene to the meniscus. J Bone Joint Surg Am, 1999, 81(7): 918-25.
[91] Steinert AF, Palmer GD, Capito R, et al. Genetically enhanced engineering of meniscus tissue using ex vivo delivery of transforming growth factor-beta-1 complementary deoxyribonucleic acid. Tissue Eng, 2007, 13(9): 2227-37.
[92] Englert C, Blunk T, Fierlbeck J, et al. Steroid hormones strongly support bovine articular cartilage integration in the absence of IL-1β Arthritis Rheum, 2006, 54: 3890-7.
[2]Chen E,Maffulli N,Chan KM.Knee injuries produced by recreational sports follow a different pattern than casual injuries.Bull Hosp Jt Dis,1998,57:74-9.
[3]王健全,敖英芳,刘平,等.前交叉韧带股骨止点临床解剖学研究.中国运动医学杂志,2007,26(3):266-70.
[4]Gabriel MT,Wong EK,Woo SL,et al.Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads.J Orthop Res,2004,22(1):85-9.
[5]Musahl V,Lehner A,Watanabe Y,et al..Biology and biomechanics.Current Opinion in Rheumatology,2002,14(2):127-133.
[6]张东龙,高顺生.膝关节半月板的形态学研究进展及其临床意义.北京体育师范学院学报,1999,11(2):79.
[7]Brindle T,Nyland J,Johnson DL.The meniscus:review of basic principles with application to surgery and rehabilitatio.J Athl Train,2001,36(2):160-9.
[8]皇甫小桥,赵金忠.半月板重建的临床研究进展.中华创伤骨科杂志,2006,8(6):570-3.
[9]Maquet PG,Van de Berg AJ,Simonet JC.Femorotibial weight-bearing areas,Experimental determination.J Bone Join tSurg AM,1975,57:766-71.
[10]Ahmed AM,Burke DL,Yu A.In-vitro measurement of static pressure distribution in synovial joints,Part Ⅱ:Retropatellar surface.J Biomech Eng,1983,105:226-36.
[11]Wickiewicz TL.Meniscal injuries in the crnciate-deficient knee.Clin Sports Med,1990,9:681-94.
[12]Henning CE.Current status of meniscus salvage.Clin Sports Med,1990,9:567-76.
[13]Bellabarba C,Bellabarba C,Bush-Joseph CA,et al.Patterns of meniscal injury in the anterior cruciate-deficient knee:a review of the literature.Am J Orthop,1997,26:18-23.
[14]黄加张,顾湘杰,潘哲尔,等.半月板突出在膝关节骨关节炎中地位的初步研究.中国临床医学,2004,11:1102-4.
[15]吴宏斌,张景辉.兔前交叉韧带切断骨关节炎模型中MMP-1 MMP-13及TIMP的mRNA的表达研究.中国风湿病学杂志,2002,6:169-72.
[16]汪爱媛,卢世璧,马志鹏,等.压敏片成像分析系统的研制及生物力学应用.北京生物医学工程,2001,20(4):282-4.
[17]Warner JJP,Bowen MK,Deng XH,et al.Articular contact patterns of the normal glenohumeraljoint.J Shoulder Elbow Surg,1998,7(4):381-8.
[18]Thambyah A,Goh JCH,Das De S.Contact stresses in the knee joint in deep flexion.Med Eng Phys,2005,27:329-35.
[19]肖东民,陈素芳,李雄等.前交叉韧带重建方法的生物力学研究.医学临床研究,2005,22(12):1667-70.
[20]郭磊,赵玉岩,范广宇.髋臼发育不良的三维光弹力学实验研究及其临床意义.中国医科大学学报,2002,31(6):464-5.
[21]张祚福,王万春.膝关节三维有限元分析.国际骨科学杂志,2006,27(2):43-5
[22]Donahue TLH,Hull ML,Rashid MM,et al.A finite element model of the human knee joint for the study of tibio-femoral contact.J Biomech Eng,2002,124(3):273-80.
[23]国家体育总局群体司.2000年国民体质监测报告.北京:北京体育大学出版社(第1版),2002:89-91.
[24] Greis PE, Bardana DD, Holmstrom MC, et al. Meniscal injury: Ⅰ Basic science and evaluation. J Am Acad Orthop Surg , 2002,10(3): 168-76.
[25] Greis PE, Holmstrom MC, Bardana DD, et al. Meniscal injury: Ⅱ Management. J Am Acad Orthop Surg , 2002, 10(3): 177-87.
[26] Englund M, Roos EM, Roos HP, et al. Patient-relevant outcomes, fourteen years after menisectomy: influence of type of meniscial tear and size of resection. Rheumatology (Oxford), 2001,40:631-9.
[27] Levy IM, Torzilli PA, Gould JD, et al. The effect of lateral meniscectomy on motion of the knee, J Bone Joint Surg Am, 1989, 71 : 401-6.
[28] Levy IM, Torzilli PA, Warren RF. The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Joint Surg Am, 1982,64:883-8.
[29] Naranje S, Mittal R, Nag H, et al. Arthroscopic and magnetic resonance imaging evaluation of meniscus lesions in the chronic anterior cruciate ligament-deficient knee. Arthroscopy, 2008, 24: 1045-51.
[30] Palmer I. On the injuries to the ligaments of the knee joint: a clinical study. Acta Chir Scand, 1938, 91: 1-282.
[31] Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res, 1975, (106): 216-31.
[32] Harner CD, Back GH, Vogrin TM, et al. Quantitative analysis of human cruciate ligament insertions. Arthroscopy, 1999, 15(7): 741-9.
[33] Mochizuki T, Muneta T, Nagase T, et al. Cadaveric knee observation study for describing anatomic femoral tunnel placement for two-bundle anterior cruciate ligament reconstruction. Arthroseopy, 2006, 22(4): 356-61.
[34] Amis AA, Dawkins GP. Functional anatomy of the anterior cruciate ligament, Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br, 1991, 73(2): 260-7.
[35]Norwood LA,Cross MJ.Anterior cruciate ligament:functional anatomy of its bundles in rotatory instabilities.Am J Sports Med,1979,7(1):23-6.
[36]Takahashi M,Doi M,Abe M,et al.Anatomical study of the femoral and tibial insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament.Am J Sports Med,2006,34(5):787-92.
[37]Odensten M,Gillquist J.Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction.J Bone Joint Surg,1985,67A:257-62.
[38]Hirokawa S,Yamamoto K,Kawada T.Circumferential measurement and anslysis of strain distribution in the human ACL using a photoelastic coating method.J Biomech,2001,34:1135-43.
[39]张文强,王成琪,唐胜建,等.单束单隧道与双束双隧道重建膝前交叉韧带的生物力学对比研究,中国矫形外科杂志,2006,14(10):757-9.
[40]Getelman MH,Friedman MJ.Revision anterior cruciate ligament reconstruct -ion surgery.J Am Acad Orthop Surg,1999,7:189-98.
[41]Vergis A,Gillquist J.Gratf failure in intra-articular ACL reconstructions:a review of the literature.Arthroscopy,1995,11:312-21.
[42]Hogervorst T,Rijcken THP,Rucker D,et al.Changes in bone scans after anterior cruciate ligament reconstruction:A prospective study.Am J Sports Med,2002,30:823-33.
[43]Frank CB,Jackson DW.Current concepts review:The science of reconstruction of the anterior cruciate ligament.J Bone Joint Surg AM,1997,79:1556-76.
[44]Papageorgiou CD,Gil JE,Kanamori A,et al.The biomechanical interdependence between the anterior cruciate ligament replacement graft and the medial meniscus.Am J Sports Med,2001,29:226-31.
[45]Takeuchi R,Saito T,Mituhashi S,et al.Double-bundle anatomic anterior cruciate ligament reconstruction using bone-hamstring-bone composite graft. Arthrocopy,2002,18:550-5.
[46]Yagi M,Wong EK,Kananmori A,et al.Biomechanical analysis of an anatomic ACL reconstruction.Am J Sports Med,2002,30:660-7.
[47]Maffulli N,Binfield PM,King JB.Articular cartilage lesions in the symptomatic anterior cruciate ligament-deficient knee.Arthroscopy,2003,19:685-90.
[48]Ichinohe S,Yoshida M,Murakami H,et al.Meniscal tearing after ACL reconstruction.J Orthop Surg,2000,8:53-9.
[49]Tayton E,Verma R,Higgins B,et al.A correlation of time with meniscal tears in anterior cruciate ligament deficiency:stratifying the risk of surgical delay.Arthroscopy,2009,17(1):30-4.
[50]Lohmander LS,Englund PM,Dahl LL,et al.The long-term consequence of anterior cruciate ligament and meniscus injuries:osteoarthritis.Am J Sports Med,2007,35(10):1756-69.
[51]Murrell GA,Maddali S,,Horovitz L,et al.The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss.Am J Sports Med,2001,29(1):9-14.
[52]McDermott ID,Masouros SD,Amis AA.Biomechanics of the menisci of the knee.Current Orthop,2008,22(3):193-201.
[1]Englund M,Roos EM,Roos HP,et al.Patient-relevant outcomes fourteen years after menisectomy:influence of type of meniscial tear and size of resection.Rheumatology(Oxford),2001,40:631-9.
[2]贺石林,李元建.医学科研方法学.人民军医出版社,第1版,2001:229-32.
[3]李瑞锡,李静.家兔膝关节半月板的形态观察及图象测量.云南师范大学学报:自然科学版,1992,12:74-8.
[4]Muir H.The chondrocyte,architect of cartilage,Biomechanics,structure,function and molecular biology of cartilage matrix macromolecules.Bioessays,1995,17(12):1039-48.
[5]陈百成,张静.骨关节炎.北京:人民卫生出版社,2004.154-77.
[6]吴宏斌,杜靖远,胡勇,等.兔前交叉韧带切断骨关节炎模型中MMP-1MMP-13及TIMP-1的mRNA表达研究.中华风湿病学杂志,2002,6(3):169-72.
[7]Petersen W,Tillmann B.Collagenous fibral texture of the human knee joint menisci.AnatEmbryol(Berl),1998,197:317-24.
[8]Tanaka T,Fujii K,Kumagae Y.Comparation of biochemical characteristics of cultured fibrochondrocytes isolated from the inner and outer regions of human meniscius.Knee Surg Sports Traumatol Arthrosc,1999,7:75-80.
[9]Kobayashi M,Squires GR,Mousa A,et al.Role of interleukin-1 and tumor necrosis factor alpha in matrix degradation of human osteoarthritic cartelage.Arthritis Rheum,2005,52:128-35.
[10]Pelletier JP,McCollum R,Cloutier JM,et al.Synthesis of metalloproteases and interleukin 6(IL-6) in human osteoarthritic synovial membrane is an IL-1 mediated process.J Rheumatol Suppl,1995,43:109-14.
[11]Fell HB,Jubb RW.The effect of synovial tissue on the breakdown of articular cartilage in organ culture.Arthritis Rheum,1977,20:1359-71.
[12]Schwab W,Schlze-Tanzil G,Mobasheri A,et al.Interleukin-lbeta-induced expression of the urokinase-type plasminogen activator receptor and its co-localization with MMPs in human articular chondrocytes.Histol Histopathol,2004,19:105-12.
[13]Blanco FJ,Lotz M.IL-1-induced nitric oxide inhibits chondrocyte proliferation via proteoglycane E2.Exp Cell Res,1995,218:319-25.
[14]Iannone F,Lapadula G.The pathophysiology of osteoarthritis.Aging Clin and Exp Res,2003,15:364-72.
[15]Arner EC,Tortorella MD.Signal transduction through chondrocyte integrin receptors induces matrix metalloproteinase synthesis and synergizes with interleukin-1.Arthritis Rheum,1995,38:1304-14.
[16]Fernandes JC,Martel-Pelletier J,Pelletier JP.The role of cytokines in osteoarthritis pathophysiology.Biorheology,2002,39:237-46.
[17]Dayer JM.The saga of the discovery of IL-1 and TNF and their specific inhibitors in the pathogenesis and treatment of rheumatoid arthritis.Joint Bone Spine,2002,69:123-32.
[18]Vuolteenaho K,Moilanen T,Hamalainen M,et al.Regulation of nitric oxide production in osteoarthritic and rheumatoid cartilage-Role of endogenous IL-1 inhibitors.Scand J Rheumatol,2003,32:19-24.
[19]Murakami S,Lefebvre V,de Crombrugghe B.Potent inhibition of the master chondrogenic factor Sox9 gene by interleukin-1 and tumor necrosis factor-alpha.J Biol Chem,2000,275(5):3687-92.
[20]Heraud F,Heraud A,Harmand MF.Apoptosis in normal and osteoarthritic human articular cartilage.Ann Rheum Dis,2000,59(12):959-65.
[21]陈延文,王艾林,周建平,等.关节软骨细胞凋亡.中国医学科学院学报,2000,22(4):364-5.
[22]Vuolteenaho K,Moilanen T,Knowles RG,et al.The role of nitric oxide in osteoarthritis.Scand J Rheumatol,2007,36:247-51.
[23]Pelletier JP,Faure MP,Dibattista JA,et al.Coordinate synthesis of stromelysin interleukin-1 and oncogene proteins in experimental osteoarthritis:An immunohistochemical study.Am J Pathol,1993,142:95-105.
[24]Joos H,Albrecht WG,Laufer S,et al.IL-1 beta regulates FHL-2 and other cytoskeleton-related genes in human chondrocytes.Molecular Medicine,2008,14:150-9.
[25]Cawston TE,Billington C.Metalloproteinases in the rheumatic diseases.J Pathol,1996,180(2):115-7.
[26]刘智敏,周总光.基质金属蛋白酶的结构-功能和调节.生物医学工程学杂志,2002,19(4):680-3.
[27]Nagase H,Woessner JF.Matrix metalloproteinases.J Biol Chem,1999,274(31):21491-4.
[28]Gomez DE,Alonso DF,Yoshiji H,et al.Tissue inhibitors of metalloproteinases:structure,regulation and biological functions.Eur J Cell Biol,1997,74(2):111-22.
[29]Ishiguro N,Ito T,Oguchi T,et al.Relationships of matrix metalloproteinases and their inhibitors to cartilage proteoglycan and collagen turnover and inflammation as revealed by analyses of synovial fluids from patients with rheumatoid arthritis.Arthritis Rheum,2001,44(11):2503-11.
[30]Ogata Y,Miura K,Ohkita A,et al.Imbalance between matrix metalloproteinase 9 and tissue inhibitor of metalloproteinases 1 expression by tumor cells implicated in liver metastasis from colorectal carcinoma.Kurume Med J,2001,48(3):211-8.
[31]Close DR.Matrix metalloproteinase inhibitors in rheumatic diseases.Ann Rheum Dis,2001,60(Suppl 3):62-7.
[32]Lafleur MA,Hollenberg MD,Atkinson SJ,et al.Activation of pro-(matrix metalloproteinase-2)(pro-MMP-2) by thrombin is membrane-type-MMP -dependent in human umbilical vein endothelial cells and generates a distinct 63 kDa active species.Biochem J,2001,357(Pt 1):107-15.
[33]Murphy G,Stanton H,Cowell S,et al.Mechanisms for pro matrix metalloproteinase activation.APMIS,1999,107(1):38-44.
[34]Buckwalter JA,Martin JA.Osteoarthritis.Adv Drug Deliv Rev,2006,58(2):150.
[35]姚如愚,张晓.基质金属蛋白酶与骨关节炎.国外医学内科学分册,2001,28(4):159-62.
[36]Sanchez C,Deberg MA,Piccardi N,et al.Osteoblasts from the scleraotic subchondral bone downregulate aggrecan but upregulate metalloproteinases expression by chondrocytes,This effect is mimicked by interleukin-6,-1beta and oncostatin M pre-treated nonsclerotic osteoblasts.Osteoarthritis Cartilag -e,2005,13(11):979.
[37]Legendre F,Bogdanowicz P,Boumediene K,et al.Role of interleukin 6(IL-6)/(IL-6R)-induced signal tranducers and activators of transcription and mitogen activated protein kinase/extracellular.J Rheumatol,2005,32(7):1307.
[38]郭静,张娜,闫冰,等.MMP-13与IL-6在骨性关节炎相关性表达的研究.华北煤炭医学院学报,2008,10(3):297-9.
[39]亓建洪,赵庆华,刘延菊,等.白细胞介素-1 β对人软骨细胞基质金属蛋白酶-13mRNA表达的作用,中华风湿病学杂志,2005,9(3):138-41.
[40]Aida Y,Maeno M,Suzuki N,et al.The effect of IL-1 beta on the expression of matrix metalloproteinases and tissue inhibitor of matrix metalloproteinases in human chondrocytes.Life Sci,2005,77(25):3210-21.
[41]Hellio Le,Graverand MP,Eggerer J,et al.Matrix metalloproteinase-13expression in rabbit knee joint connective tissues:influence of maturation and response to injury,Matrix Biol 2000,19:431-41.
[42]Fernandes JC,Martel-Pelletier J,Lascau-Coman V,et al.Collagenase-1 and collagenase-3 synthesis in normal and early experimental osteoarthritic cani -ne cartilage:Animmunohistochemical study,Rheumatol,1998,25:1585-94
[43]Bluteau G,Conrozier T,Mathieu P,et al.Matrix metalloproteinase-1,-3,-13 and aggrecanase-1 and-2 are differentially expressed in experimental osteoarthritis.Biochim Biophys Acta,2001,1526:147-58.
[44]Oh H,Yang S,Park M,et al.Matrix Metalloproteinase(MMP)-12Regulates MMP-9 Expression in Interleukin-1-Treated Articular chondrocytes,J Cellular Biochemistry,2008,105(6):1443-50.
[45]Hashimoto S,Ochs RL,Komiya S,et al.Linkage of chondrocyte apoptosis and cartilage degradation in human osteoarthritis,Arthritis Rheumm,1998,41:1632-8.
[46]Murrell GA,Maddali S,Horovitz L,et al.The effect of time course after anterior cruciate ligament injury in correlateion with meniscal and cartilage loss.AM J Sports Med,2001,29:9-14.
[47]Deschner J,Rath-Deschner B,Agarwal S.Regulation of matrix metalloproteinase expression by dynamic tensile strain in rat fibrochondrocytes.OsteoArthritis and Cartilage,2006,14:264-72.
[48]薛海滨,敖英芳,于长隆,等.前交叉韧带断裂和重建对膝关节软骨退变影响的实验研究,中华外科杂志,2002,40(4):304-7.
[49]管剑龙,施桂英.基质金属蛋白酶与骨关节炎.中华风湿病学杂志,2000,4:54-6.
[1]Kocher MS,Klingele K,Rassman SO.Meniscal disorders:normal discoid and cysts.Orthop Clin North Am,2003,34(3):329-40.
[2]Greis PE,Bardana DD,Holmstrom MC,et al.Meniscal injury:Ⅰ.Basic science and evaluation.J Am Acad Orthop Surg,2002,10(3):168-76.
[3]Greis PE,Holmstrom MC,Bardana DD,et al.Meniscal injury:ⅡManagement.J Am Acad Orthop Surg,2002,10(3):177-87.
[4]吴海山,徐青雷.膝半月板外科与组织工程学重建.第二军医大学出版社,第1版,1999:3-8.
[5]Vedi V,Williams A,Tennant SJ,et al.Meniscal movement:An in-vivo study using dynamoic MRI.J Bone Joint Surg Br,1999,81:37-41.
[6]Thompson WO,Thaete FL,Fu FH,et al.Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images.Am J sports Med,1991,19(3):210-15.
[7]Bylski-Austrow DI,Ciarelli MJ,Kayner DC,et al.Displacements of the mencici under joint load:an vitro study in human knees.J Biomech,1994,27:421-31.
[8]Pagnani MJ,Cooper DE,Warren RF.Extrusion of the medial meniscus.Arthroscopy,1991,7(3):297-300.
[9]Englund M,Roos EM,Roos HP,et al.Patient-relevant outcomes fourteen years after meniscectomy:influence of type of meniscal tear and size of resection.Rheumatology(Oxford)A2001,40(6):631-9.
[10]Renstrom]B,Johnson RJ.Unatomy and biomechanics of the menisci.Clin sports Med,1990,9:523-38.
[11]Qreitenseher MJ,Rrattnig S,Dobrocky I,et al.MR imaging of meniscal subluxation in the knee.Acta Radiol,1997,38:876-9.
[12]George M,Wall FJ.Locked knee caused by meniscal subluxation MR imaging and arthroscopic verification.Arthroscopy,2003,19:885-8.
[13]Kenny C.Radial displacement of the medial meniscus and Fairbank's signs.Clin Orthop Relat Res,1997,(339):163-73.
[14]Miller TT,Staron RB,Feldman F,et al.Meniscal position on routine MR imaging of the knee.Okeletal Radiol,1997,26:424-7.
[15]Smith FB,Blair HC.Tibial collaterall ligament strain due to occult derangements of the medial meniscus:conformed by operation in thirty case.J Bone Joint Surg Am,1954,36-A:88-93;passim.
[16]陈坚,吕厚山,劳山,等.膝关节半月板周围性移位现象及其临床意义.中华骨科杂志,2005,(25)7:426-9.
[17]Breitenseher MJ,TrattnigS,Dobrocky I,et al.MR imaging of meniscal subluxation in the knee.Acta Radiol,1997,38:876-9.
[18]Sugita T,Kawamata T,Ohnuma M,et al.Radial displacement of the medial meniscus in varus osteoarthritis of the knee.Clin Orthop Relat Res,2001,8:171-7.
[19]王希强,刘世恩,郭永存,等.膝关节半月板损伤 MRI 分级与半月板半脱位的相关性分析.中国临床医学影像杂志,2007,18:657-60.
[20]陈坚,吕厚山,劳山,等.膝关节半月板周围性移位现象的初步 MRI 研究.中华放射学杂志,2006,40:612-5.
[21]Renstrom P,Johnson RJ.Anatomy and biomechanics of the menisci.Clin Sports Med,1990,9:523-38.
[22]黄竟敏,王植,赵力,等.半月板损伤的 MRI 诊断与关节镜所见的比较研究.中华骨科杂志,2003,23:403-7.
[23]Naredo E,Cabero F,Palop MJ,et al.Ultrasonographic findings in knee osteoarthritis:a comparative study with clinical and radiogramphic assessment.Osteoarthritis and Cartilage,2005,13(7):568-74.
[24]Ko CH,Chan KK,Peng HL.Sonographic imaging of meniscal subluxation in patients with radiographic knee osteoarthritis.Journal of the Formosan Medical Association,2007,106(9):700-7.
[25]Verdonk P,Depaepe Y,Desmyter S,et al.Normal and transplanted lateral knee menisci:evaluation of extrusion using magnetic resonance imaging and ultrasound.Knee Surgery Sports Traumatology Arthroscopy,2004,12(5):411-9.
[26]Tienen TG,Buma P,Scholten JGF,et al.Displacement of the medial meniscus within the passive motion characteristics of the human knee joint:an RSA study in human cadaver knees.Knee Surg Sports Traumatol Arthrosc,2005,13(4):287-92.
[27]Boxheimer L,Lutz M,Treiber K,et al.MRI of the knee:position related changes of the menisci in asympotamtic volunteers.Invest Radiol,2004,39:254-63.
[28]Ikeuchi K,Sakoda H,Sakaue R,et al.A new method for accurate measurement of displaycement of the knee menisci.Pro Inst Mech Eng,1998,212(3):183-8.
[29]黄加张,顾湘杰,潘哲尔,等.半月板突出在膝关节骨关节炎中地位的初步研究.中国临床医学,2004,11:1102-4.
[30]周自明,丁永生,田芳,等.膝关节半月板周缘脱位征象的 MRI 研究及其临床意义初探.医学影像杂志,2008,18(9):1055-8.
[31]蒋欣,李箭,裴福兴,等.人体正常半月板的大体解剖学测量与半月板重建的关系.四川医学,2002,23:795-6.
[32]Costa RC,Morrison WB.Medial meniscus extrusion on knee MRI:is extent associated with severity of degeneration or type of tear ? AJR,2004,183:7-23.
[33]范宏斌,张春礼,李明全,等.前交叉韧带断裂后半月板和软骨损伤的临床研究.中华创伤杂志,2004,20:73-6.
[34]Marzo Jm,Gurske-Deperio J.Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications.Am J Sports Med,2009,37(1):124-9.
[1]Clark CR,Ogden JA.Development of the Meniscus of the Human Knee Joint.J Bone Joint Surg Am,1983,65:538-47.
[2]Brindle T,Nyland J,Johnson DL.The meniscus:review of basic principles with application to surgery and rehabilitation.J Athl Train,2001,36(2):160-9.
[3]Arnoczky SP,Warren RF.Microvaculature of the human meniscus.AM J Spots Med,1982,10:90-5.
[4]Radin EL,Delamotte F,Maquet P.Role of the menisci in the distribution of stresss in the knee.Clin Orthop,1984,185:290-4.
[5]Baratz ME,Mengator R.Meniscal tears:The effect of meniscectomy and repair on intra-articular contact areas and stress in the human knee.Am J Sports Med,1986,14:270-5.
[6]Ahmed AM,Burke DL.In vitro measurement of static pressure distribution in synovial joints Part-Ⅰ Tibial surface of the knee,J Biomech Eng,1983,105:216-25.
[7]Levy IM,Torzdli PA,Warrent RF.The effect of medial meniscetomy on anterior-posterior motion of the knee.Bone Joint Surg Am 1982,84: 883-8.
[8]马楚平,梁江山,何光联,等.半月板损伤关节镜下的处理.实用骨科杂志,2007,3:139-41.
[9]张文涛,黄英,卢世璧.3种下蹲试验对半月板损伤的诊断意义.实用骨科杂志,2006,6:511-3.
[10]赵汉平,孙磊,李佩佳,等.临床检查对半月板损伤的价值.中国矫形外科杂志,2002,6:643-5.
[11]戴刚,张卫东,王东武,等.关节镜下手术治疗膝半月板损伤478例流行病学调查分析.重庆医学,2006,13:1168-70.
[12]王亦璁.创伤早期处理.北京:人民卫生出版社,1994:122-5.
[13]杨君礼,史振满,许刚,等.改良蹲走试验在诊断膝关节半月板损伤中的临床意义.骨与关节损伤杂志2003,18(7)447-8.
[14]田野,白伦浩,付勤.麦氏试验对半月板损伤和膝关节间隙内疾病的诊断价值比较.中国骨伤,2007,20(11):736-8.
[15]Karachalios T,Hantes M,Zibis AH,et al.Diagnostic accuracy of a new clinical test(the Thessaly test)for early detection of meniscal tears.J Bone Joint Surg(Am),2005,87(5):955-62.
[16]赵汉平,孙磊,李佩佳,等.临床检查对半月板损伤的价值.中国矫形外科杂志,2002,6:643-45.
[17]吴清君.40例膝关节绞锁的关节镜所见分析.中医正骨,2006,1049-50.
[18]万斌,吕天润,吕征.103例老年患者内侧半月板后角损伤的治疗.南京医科大学学报,2007,1:89-90.
[19]燕树义,高晓荣,李学民,等.中老年人半月板损伤的关节镜诊断治疗.中国修复重建外科杂志,6:623-6.
[20]冯瑛琦,徐斌,徐洪港,等.膝关节弹响的发生和关节镜诊治.安徽医科大学学报,2006,1:94-6.
[21]于利,王立德,吕德成,等.膝关节伸直受限的关节镜下治疗.中华外科杂志,2006,44(12):833-5.
[22]胥少汀,葛宝丰,徐印坎,等.实用骨科学(第3版).北京:人民军医出版社,2005.1844.
[23]白卫东,娄思权.半月板损伤几种诊断方法的评价:物理诊断、关节造影、B超、MRI与关节镜诊断比较.骨与关节损伤杂志,1995,10:1-7.
[24]Duras JM.Meniscal abnormalities:prospective correlation of double contrast arthrography and arthroscopy.Ridiography,1986,160:453.
[25]Kimorl K.Evaluation of arthrography and arthroscopy for lesions of the posteromedical comer of the knee.Am J Sports Med,1989,17(5):638.
[26]Feller JA,Webster KE.Clinical value of magnetic resonance imaging of the knee.ANI Surg,2001,71(9):531-7.
[27]陈海南,董启榕,汪益,等.低场强磁共振成像诊断半月板撕裂的准确性研究.中华创伤杂志,2004,2:83-4.
[28]Vincken PW,Braak BP,ven Erkell AR,et al.Effectiveness of MR imaging in selection of patients for arthroscopy of the knee.Radiology,2002,223:739-46.
[29]Magee T,Williams D.3.0-T MRI ofmeniscal tears.AJR,2006,8:371-5.
[30]De Smet AA,Tuite MJ.Use of the"two-slice-touch"rule for the MKI diagnosis of meniscal tears.AJR Am J Roentgenol,2006,4:911-4.
[31]Thomas S,Pullagura M,Robinson E,et al.The value of magnetic resonance imaging in our current management of ACL and meniscal injuris.Knee Surg Sports Traumatol Arth,2007,5:533-6.
[32]Friedl W,Glaser F.Dynamic sonography in the diagnosis of ligament and meniscal injuries of the kne.Arch Orthop Trauma Surg,1991,110:132.
[33]齐晓东,王荣,黄洁红.半月板损伤的MRI诊断及临床价值.浙江临床医学,2006,(8)7:767.
[34]王韶进,戴国锋,刘琦.B超在半月板损伤中的诊断价值.山东医科大学学报,2001,39(6):542-3.
[35]施林枫,胡新娥,宋鲁梅,等.B超对膝关节半月板损伤的诊断价值.浙江临床医学,2007,9(11):1555.
[36]尹东,孙可,满育平,等.膝半月板损伤的临床、MRI及关节镜对比研究.中国矫形外科杂志,2007,15(24):1872-4.
[37]Ryzewicz M,Peterson B,Siparsky PN,et al.The diagnosis of meniscus tears:the role of MRI and clinical examination.Clin Orthop,2007,455:123-33.
[38]McCarty EC,Marx RG,DeHaven KE.Meniscus repair:Considerations in treatment and update of clinical results.Clin Orthop,2002,402:122-34.
[39]Morrissey MC,Goodwin PC.Correlates of knee extensor training load used in rehabilitation after knee surgery.J Strength Cond Res,2007,21(4):1050-2.
[40]戴刚,张卫东,王东武,等.关节镜下手术治疗膝半月板损伤478例流行病学调查分析.重庆医学,2006,13:1168-70.
[41]van Tienen TG,Heijkants RG,de Groot JH,et al.Presence and mechanism of knee articular cartilage degeneration after meniscal reconstruction in dogs.Osteoarthritis Cartilage,2003,11(1):78-84.
[42]Kamei G,Sumen Y,Sakuridani K.Evaluation of cartilage defect at medial femoral condyle in early osteoarthritis of the knee.J Chugoku Shikoku Orthop Association,2006,18(2):229-33.
[43]Felix NA,Paulos LE.Current status of meniscal transplantation.Knee,2003,10(1):13-7.
[44] Heckmann TP, Barber-Westin SD, Noyes FR. Meniscal repair and transplantation: Indications, techniques, rehabilitation, and clinical outcome. J Orthop Sports PHYs Then 2006, 36(10): 795-814.
[45] Barber FA, McGarry JE. Meniscal repair techniques. Sports Med Arthrosc, 2007, 15 (4): 199-207.
[46] Steenbrugge F, Verdonk R, Verstraete K. Long-term assessment of arthroscopic meniscus repair: a 13-year follow-up study. Knee, 2002, 9: 181-7.
[47] Lohmander LS, Englund PM, Dahl LL, et al. The long-term consequence of anterior cruciate ligament and meniscus injuries. Osteoarthritis Am J Sports Med, 2007, 35(10): 1756-69.
[48] KimuraM, ShirakuraK, Hasegawa A, et al. Second look arthroscopy after meniscal repair. Factors affecting the healing rate. Clin Orthop Relat Res, 1995, (314): 185-91.
[49] Swenson TM. The use of exogenous fibrin clot to supplement meniscal surgery techniques. Orthopedics, 2007, 30(9): 718-23.
[50] Rodeo SA. Menical allografts-where do we stand?Am J Sports Med , 2001, 29(2): 246-61.
[51] Verdonk R, Almqvist KF, Huysse W, et al. Meniscal allografts: Indications and outcomes. Sports Med Arthrosc, 2007, 15(3): 121-5.
[52] KohnD, Wirth CJ, Reiss G, et al. Medial meniscus replacement by a tendon autograft experiments in sheep, J Bone Joint Surg Br, 1992,74(6): 910-12.
[53] Mora G, Alvarez E, Ripalda P, et al. Articular cartilage degeneration after frozen meniscus and Achilles tendon allograft transplantation: Experimental study in sheep. Arthroscopy, 2003, 19(8): 833-41.
[54] Johnson LL, Feagin JA. Autogenous tendon graft substitution for absent knee joint meniscus:A pilot study.Arthroscopy,2000,16(2):191-6.
[55]Shaffer B,Kennedy S,Klimkiewicz J,et al.Preoperative sizing of meniscal allografts in meniscus transplantation.Am J Sports Med,2000,28(4):524-33.
[56]Fox MG.MR imaging of the meniscus:Review,current trends,and clinical implications.Radiologic Clinics of North America,2007,45(6):1033-53.
[57]Crawford R,Walley G,Bridgman S,et al.Magnetic resonance imag -ing versus arthroscopy in the diagnosis of knee pathology,concentrating on meniscal lesions and ACL tears:a systematic review.Br Med Bull,2007,84:5-23.
[58]Wirth CJ,Peters G,Milachowski KA,et al.Long-term results of meniscal allograff transplantation.AMJ Sports Med,2002,30(2):174-81.
[59]VerdonkR.Meniscal transplantation.Acta Orthop Belg,2002,68:118-27.
[60]Kurzweil PR,Friedman MJ.Meniscus:Resection,repair and replace -ment.Arthroscopy,2002,18:33-9.
[61]Stollsteimer GT,Shelton WR,Dukes A,et al.Meniscal allograff transpl -antation:a 1 to 5-year follow-up of 22 patients.Arthroscopy,2000,16(4):343-7.
[62]van Arkel ER,de Boer HH.Survival analysis of human meniscal transplantation.J Bone Joint Surg Br,2002,84(2):227-31.
[63]Verdonk PCM,DemurieA,Almqvist F,et al.Transplantation of viable meniscal allograft:Survivor ship analysis and clinical outcome of one hundred cases.J Bone Joint Surg Am,2005,87(4):715-24.
[64]Matava MJ.Meniscal allograff transplantation:a systematic review.Clin Orthop,2007,455:142-57.
[65]余家阔,谢兴,张继英,等.异种异体和同种异体半月板移植修复兔 膝关节半月板缺失的预后研究.中国运动医学杂志,2004, 6： 604-8.
[66] Welch JA, Montgomery RD, Lenz SD, et al. Evaluation of small- -intestinal submucosa implants for repair of meniscal defects in dogs. J Vet Res(Am), 2002, 3: 427-31.
[67] Cook JL, Fox DB, Malaviya P, et al. Long-term outcome for large meniscal defects treated with small intestinal submucosa in a dog model. J Sports Med(Am), 2006, 34: 32-42.
[68] Messner K, Gillquist J. Prosthetic replacement of the rabbit medial meniscus. J Biomed Mater Res, 1993, 27: 1165-73.
[69] Messner K. The concept of a permanent synthetic meniscus prosthesis: a critical discussion after 5 years of experimental investigations using Dacron and Teflon implants. Biomaterials, 1994, 15: 243-50.
[70] Kobayashi M. A study of polyvinyl alcohol-hydrogel(PVA-H) artifcial meniscus in vivo. Biomed Mater Eng, 2004, 14: 505-15.
[71] Kobayashi M, Toguehida J, Oka M. Development of an artificial meniscus using polyvinyl alcohol-hydrogel for early return to, and continuance of, athletic life in sport spersons with severe meniscus injury. Knee, 2003, 10: 53.
[72] Hoben GM, Athanasiou KA. Meniscal repair with fibrocartilage engineering. Sports Med Arthrosc, 2006, 14(3): 129-37.
[73] Caplan AL. Adult mesenchymal stem cells for tissue engineering versus regenerative medicine. J Cell Physiol, 2007, 213(2):341-7.
[74] Dietmar WH. Scafolds in tissue engineering bone and cartilage. J Biomater, 2000, 21:2529-43.
[75] Kobayashi M. A study of polyvinyl alcohol-hydrogel artificial meniscius in vivo. Biomed Mater Eng, 2004, 14(4): 505-15.
[76] Stone KR, SteadmanJR, RodkeyWG, et al. Regeneration of meniscal cartilage with use of a collagen scaffold:Analysis of preliminary data.J Bone Joint Surg Am,1997,79(12):1770-7.
[77]Marijnissen WJ,Van Osch GJ,Aigner J,et al.Alginate as a chondrocyte -delivery substance in combination with a non-woven scaffold for cartilage tisue engineering.Biomaterials,2002,23(6):1511-7.
[78]Reguzzoni M,Manelli A,Ronge M,et al.Histology and ultrastructure of a tisue-engineered collagen meniscus before and after implantation.J Biomed Mater Res B ApplBiomater,2005,74B(2):808-16.
[79]叶川,邓展生,申定珠,等.外消旋聚丙交酯与人胚半月板细胞构建复合物的研究.贵阳医学院学报,2007,32(6):591-3.
[80]刘和风,王俊飞,黄际河,等.丝素-胶原复合物半月板支架负载纤维软骨细胞的实验观察.山东医药,2008,48(15):27-8.
[81]Bodin A,Concaro S,Brittberg M,et al.Bacterial cellulose as a potential meniscus implant.J Tissue Eng Regen Med,2007,1(5):406-8.
[82]Hennerbichler A,Moutos FT,Hennerbichler D,et al.Interleukin-1 and tumor necrosis factor alpha inhibit repair of the porcine meniscus in vitro.OsteoarthritisCartilage,2007,15(9):1053-61.
[83]Ivkovic A,Pascher A,Hudetz D,et al.Current concepts in gene therapy of the musculoskeletal system,Acta Chit Orthop Traumatol Cech,2006,73(2):115-22.
[84]Nakata K,Shino K,Hamada M,et al.Human meniscus cell:Characterization of the primary culture and use for tissue engineering.Clin Orthop Relat Res,2001,391:208-18.
[85]Zaleskas JM,Kinner B,Frcyman TM,et al.Growth factor regulation of smoth muscle actin expression and contraction of human articular chondrocytes and meniscal cells in a collagen-GAG matrix.Exp Cell Res,2001,270(1):21-31.
[86] Pangborn CA, Athanasiou KA. Effects of growthfactors on meniscal fibrechondrocytes. Tissue Eng, 2005, 11: 1141-8.
[87] Hidaka C, Ibarra C, Hannafm JA, et al. Formation of vascularized meniscal tissue by combining gene therapy with tissue engineering. Tissue Eng, 2002, 8(1): 93-105.
[88] Bhargava MM, Hidaka C, Hannafm JA, et al. Effects of hepatocyte growth factor and platelet-derived growth factor on the repair of meniscal defects in vitro. In Vitro Cell Dev Biol Anim, 2005, 41: 305-10.
[89] IshidaK, KurodaR, MiwaM, et al. The regenerative effects of platelet rich plasma on meniscal cells in vitro and its in vivo application with biodegradable gelatin hydrogel. Tissue Eng, 2007, 13(5): 1103-12.
[90] Goto H , Shuler FD, Lamsam C, et al. Transfer of lacZ marker gene to the meniscus. J Bone Joint Surg Am, 1999, 81(7): 918-25.
[91] Steinert AF, Palmer GD, Capito R, et al. Genetically enhanced engineering of meniscus tissue using ex vivo delivery of transforming growth factor-beta-1 complementary deoxyribonucleic acid. Tissue Eng, 2007, 13(9): 2227-37.
[92] Englert C, Blunk T, Fierlbeck J, et al. Steroid hormones strongly support bovine articular cartilage integration in the absence of IL-1β Arthritis Rheum, 2006, 54: 3890-7.