目的：通过建立兔前交叉韧带重建模型，分别对实验标本进行组织学及生物力学研究，为临床上丹红注射液是否能影响腱-骨愈合提供参考。方法：成年新西兰兔20只，膝关节40个，随机分为丹红注射液组（观察组）及空白对照组，每组10只。所有动物均行自体跟腱移植重建双侧前交叉韧带。观察组腱-骨界面注射丹红注射液，对照组注射生理盐水。在术后第4周、8周时处死观察组和对照组各5只兔子。每个时间段处死的兔子中，观察组5只兔子共10个膝关节中，取5个作组织学观察，剩余的5个作抗拉力生物力学测试。结果：组织学观察发现：术后4周观察组可见成纤维细胞明显增生，以及少量排列有序的胶原纤维，同时腱骨界面可见少量的新血管生成，成软骨细胞增生，肌腱和骨隧道间间隙减小。对照组骨隧道和肌腱间有新生肉芽组织和少量成纤维细胞增生，腱骨界面可见少量的胶原纤维，但排列疏松且不规则。术后8周观察组骨隧道和移植肌腱间可见较多且排列整齐胶原纤维，腱骨界面更成熟，并可见类似垂直胶原纤维。对照组腱骨界面可见大量成纤维细胞，胶原纤维较多排列仍不规则，腱骨界面可见少量骨组织生成，两组界面形态学分布差异有统计学意义（P＜0.05）。术后4周观察组腱骨界面的抗拉脱强度高于空白组，差异有统计学意义（P＜0.05）。结论：前交叉韧带重建术后应用丹红注射液处理，腱骨界面成熟成纤维细胞及Sharpey样纤维更早出现，观察组肌腱移植物的生物力学特性优于对照组，丹红注射液能促进肌腱移植物在骨隧道中的早期愈合。%Objective:To observe whether Dan-Hong injection can affect clinical tendon-bone healing, the rabbit anterior cruciate ligament reconstruction model was built and the animal experiments about histology and biomechanics were investigated. Methods: ACL reconstruction was performed on twenty healthy mature New Zealand White rabbits,with a total of 40 knees. They were randomly divided into the blank control group and the Dan-Hong injection group with 10 animals in each group. Every animal underwent the anterior cruciate ligament reconstruction operation with its Achilles tendon on both knees. Dan-Hong injection was injected into the gap of tendon-bone in the experimental groups. Nothing was used in the gap of tendon-bone in the control groups. After 4 weeks and 8 weeks of the operation, five rabbits in the experimental group and five rabbits in the control group were executed. In each period of time, five knees of the five experimental rabbits executed were taken for histological observation, and the remaining five knees were taken for biomechanical test. Results: 20 rabbits survived very well, and there were no infection in the incisions. From histological observation it was found out that in 4 weeks after the operation, there was obviously visible fibroblast cells hyperplasia in the experimental group, a small number of collagen fibers were arranged orderly, there was a small amount of new angiogenesis on the tendon bone interface and there was cartilage cell proliferation. In the controls newborn granulation tissue was found between the tendon and the bone tunnel and a small amount of fibroblasts hyperplasia was observed,and there was a small amount of loose and irregular collagen fibers on the Tendon bone interface. The gap between the tendon and the bone tunnel was smaller. In 8 weeks, in the experimental group, between the transplanted tendon and the bone tunnel, there were more visible and neat rows of collagen fibers. The interface tissue was more mature and contained some analogous perpendicular collagen bundles (Sharpey fibers). In the control group tendon bone interface was visible, large numbers of fibroblasts were seen, more collagen fibers were observed in irregular arrangement, and a small amount of bone tissue formation was found. The classification on the Yamakado type was significantly different between the two groups (P<0.05). Biomechanical examination showed that in 4 weeks the pull-out strength was stronger in the experimental group than in the control group, and there was statistical significant difference in the results (P<0.05). Conclusion:The application of Dan-Hong injection at the tendon-bone interface during ACL reconstruction resulted in the development of an intervening zone of fibro-cartilage and mature fibroblasts. The use of Dan-Hong injection was a novel method offering the potential of more physiologically earlier healing and should be conducted to improve the biomechanical strength. The present study lacks quantitative analysis of criteria, and the mechanics of the promotion of tendon-bone healing has not been absolutely clear.
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