| ObjectiveTo study the heterogeneous tendon instead of donor tendon graft tendo n defect after transplantation, the feasibility and biomechanical and mor phological change.MethodsAdult goats 24,12～15m, weight 28.5～37kg, either sex, were random ly divided into 2 groups, using tendon xenograft (pig) as the experimenta 1 group, using allogeneic tendon as the control group, all 8. After each g roup was randomly divided into 4w,8w,12w three observation phase group, n=4. Goats are used as a defect of the left hind limb Achilles tendon r epair model. To ketamine anesthesia goat, conventional incision 2cm defect caused by the Achilles tendon, tendon graft take about 6cm, slightly to maintain the ankle plantar flexor tendon defect of about 2cm, with 5/0 tendon suture needle according to the preparation of bridging the tendon defect. The whole layer of skin closure, wound with sterile gauze pieces c overed. To plaster with wire tube will be fixed on the little goat left hi nd leg plantar flexion. Postoperative antibiotics to prevent infection, no t to immunosuppressants.4w after loose plaster, free. After sub-4w,8w,12 w three time points animals were sacrificed, autopsies were performed on regional, adhesion levels naked eye, image analysis, the level of detecti on of immunity to observe pathological changes in histology and biomechan ical testing for.ResultsGross observation:the experimental group:see after the process of tendon anatomy 4w color normal, slightly enlarged stoma, scar large, hard texture, without significant tissue edema around the tendon surface is s till glossy, scar tissue adhesions around the obvious, plainDifference.In dividual and the tendon sheath were broadband-like adhesion but still sha rp separation. After 8w,12w over time, compared to the situation when the tendon allograft 4w visible fibronectin decreased slightly larger degree of sliding around no significant proliferation of granulation tissue, wi dened, after the sharp segregation see anastomosis has healed. Slightly ov er time to reduce the degree of adhesion, slip degree increased slightly. Control group:experimental group compared with the same tendon after 4w visible color normal anatomy course, a little swollen anastomosis, no sig nificant edema around the tendon surface is smooth, clear adhesive bands around the surrounding scar tissue significantly, sliding Difference. Afte r 8w,12w, adhesions around the scar tissue is still evident, sliding deg ree of improvement than before, a little soft around the scar tissue. Over time, slightly lower degree of tendon adhesion, sliding a little degree of improvement. After 4w,8w,12w experimental group and control group, no significant difference between the naked eye of adhesion (P> 0.05).Humoral immune detection:detection of the sheep interleukin-2,4 w,8 w,12w, experimental group and control group with normal, P> 0.05, and be tween the two groups no significant difference. Detection of sheep interle ukin-6,4 w, the experimental group and control group with normal, P<0.0 5, but the two groups had no significant difference.8w,12w, the test gro up and control group with normal, P> 0.05, between two groups, P> 0.05.Biomechanical testing:After 4w, the experimental group and control gr oup tendon allograft maximum tensile strength values. Can see from Table 5, 4w,8w,12w, the experimental group and control group no significant dif ference between the maximum load.4w 12w, compared with the maximum load w ere significantly different, increasing with time, but did not reach the level of normal tendon. Tips heterogeneous biomechanical properties of ten don grafts to achieve the overall levels of tendon allograft.Heterogeneou s tendon maximum load increases with time.Biopsy4w after xenograft group and the surrounding fascia and tendon recept ors with fibronectin, body surface shows fibrous tissue surrounding the n ew, local shows heterogeneous tendon fibroblasts inserted into the surfac e, the surrounding fibrous tissueshows a small amount of scattered plasma cells, small blood vessels visible stitching, and tendon adhesion recept ors close.8w collagen fibers after a relatively long before more into ten don cells, these cells have the morphological characteristics of fibrobla sts, heterogeneous tendon divided into bundles, tendon cells tendon bundl e arranged along the long axis, not quiteneat, the two ends of the tendon graft with small blood vessel formation.12w suture increased adhesion of fibers and collagen fibers into the transplant of xenogeneic long tendon, tendon allograft was more mass, divided by fibrous tissue, tendon cells and collagen fibrosis significantly, local necrotic, surrounded by inflam matory cells, the stitchingcan see a lot of proliferation of fibroblasts and capillaries, in close combination with allograft tendon. Intermediate Division tendon allograft:allograft tendon fibers of the cable is split into multiple mass, clumps of fiber degeneration, allograft tendon fibrou s tissue around it in new wrapping, partial visible newborn allogeneic te ndon fibroblasts inserted into the interiorseen in fibrous tissue surroun ding a small amount of scattered plasma cells. Tendon allograft transplant ation group were 4w, transplantation of fitness for body cells, the surfa ce layer of cells can be seen from 2 to 5 cover, constitute the new tendo n outer membrane. Internal tendon into the tendon cells found not only in distant fibers, the tendon can be seen within the beam are arranged along the long axis of tendon cells and autologous tendon has a similar shape. Both ends of the tendon graft with small blood vessels, small blood vesse ls grew into the distal segment more in and around the fascia and tendon adhesion receptor less. Similarly, no significant lymphocyte infiltration. 8w, tendon tissue with the suture between the fiber link for more. Tendon bundle of tendon cells is more neatly arranged along the long axis of the small vascular invasion more.12w more complete healing of tendon suture, overlapping boundaries between the tendon surface membrane hours, ends w ith the tendon cell proliferation can be seen the contact sheet. Transplan ted tendon collagen fibers without visible deformation of fiber bundles a rranged in neat rows, the subject is the collagen fibers, elastic fiber c ontent in very little.Morphology, and adjacent normal suture similar auto logous tendon, tendon cell composition than the latter.ConclusionFrom the immune response, tendon healing, bio-mechanics, adhesion will be considered, as a heterogeneous tendon graft tendon defect, and no dif ference in tendon allograft. |
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