가토에서 인대의 치우과정에 대한 실험적 연구 = Experimental Study on Ligament Healing in Rabbits

다국어 초록 (Multilingual Abstract)

The exact nature of ligament healing is still not documented like tendon healing and there are few reports about the role of synovial nutrition in ligament healing. The aim of this study was to investigate whether a piece of the patellar ligament can survive and how to heal in vivo in the synovial fluid of the knee joint without reestablishment of the microcirculaton in rabbit models.
Ligament healing was studied in the rabbit patellar ligament. In Group Ⅰ, the patellar ligament was harvested (4x15mm), divided transversely (4x7.5mm) and repaired with 6-0 nylon in the manner of interrupted suture. The ipsilateral knee joint then opened medially through a small incision and repaired strip of ligament was transplanted into the knee joint cavity. In Group Ⅱ, on the contralateral patellar ligament it was divided and sutured in situ with nylon 4-0. One week or two week intervals from first week to twelfth week postoperatively, the repaired ligaments were removed from the knee joint in group Ⅰ and from sutured ligaments in group Ⅱ. Both groups were compared with morphological analysis, histology and tensile strength (break point).
Macroscopically the surface of all pieces was smooth and glittering in both groups. Superficial fibroblasts were differentiated before migration and bridged the gap and produced collagen fibers but histologically there were no significant differences between the two groups. The rate of gain of tensile strength was more rapid in Group Ⅱ compared to Group Ⅰ and the rate of that was most conspicuous between four weeks and ten weeks postoperatively.
We conclude that pieces of ligament placed free in the synovial fluid of rabbit knee joint can survive without reestablishment of micricirculation and healing was accomplished successfuly even though the rate of healing was lowered than that of in situ, which supports the view that diffusion of nutrients from synovial membrane may act as an important factor in the successful healing process after reconstruction of ligaments.