【摘要】 目的　探讨加速前交叉韧带替代物血供重建的方法。方法　用狗作动物模型 ,将两侧髌韧带内侧 1 3游离 ,左侧直接包埋于髌下脂肪垫 ,右侧髌下脂肪垫切除后将韧带游离置于关节腔。术后 2、4、6、8周灌注、取材 ,观察髌下脂肪垫对游离髌韧带血供重建的影响。临床应用于前交叉韧带断裂重建术 2 0例 (Jones +髌下脂肪垫覆盖术 )。结果　被髌下脂肪垫包裹的游离髌韧带血供重建速度较未被包裹的一侧大大加快 ,其韧带内的细胞坏死、胶原崩解亦较对照组明显减少。临床应用 19例疗效满意。结论　在作交叉韧带重建手术时 ,应尽量保留并利用髌下脂肪垫等软组织 ,包裹替代物 ,以促进其血循环重建 ,减少坏死 ,保持韧带活力 ,使替代物发挥稳定膝关节的功能。更多还原

【Abstract】 Objective To explore ways of accelerating the process of revascularization of the anterior cruciate ligament after reconstruction.Method The effect of the infrapatellar fat pad on the revascularization of the isolated patellar ligament was studied in dogs.In 16 adult healthy domestic mongrel dogs,The medial one third of the patellar ligament of the left knee was isolated and embedded in the infrapatellar fat pad,while in the right knee,the infrapatellar fat pad was resected,and the isolated ligament was put into the synovial cavity.The revascularization pattern and the histological change were investigated at 2,4,8,12 weeks postoperatively.Twenty patients undertook reconstruction of the anterior cruciate ligament using the Jones method,in which the transplant was covered with the infrapatellar fat pad.Results The infrapatellar fat pad could accelerate the process of the revascularization and minimize the avascular necrosis of the isolated patellar ligament.Excellent and good results were obtained in 19 cases.Conclusion In the procedure of reconstruction of the anterior cruciate ligament,the infrapatellar fat pad must be reserved and utilized to embed the transplant,inorder to accelerate the process of revascularization,minimize the avascular necrosis and keep the transplant vitality and act as a knee stabilizer.更多还原