Comparison of knee degeneration after anterior cruciate ligament reconstruction with or without remnant preservation / 中国组织工程研究

ABSTRACT

BACKGROUND:At present, it is still unclear whether remnant-preserving anterior cruciate ligament (ACL) reconstruction can achieve better joint stability and reduce the degeneration of the articular cartilage compared with the traditional operation. OBJECTIVE: To compare knee joint degeneration after ACL reconstruction with and without remnant preservation. METHODS: A total of 60 New Zealand rabbits were randomly assigned in equal numbers to a sham group (group A), a conventional ACL reconstruction group (group B), a remnant-preserving and tensioning ACL reconstruction group (group C), and a remnant-preserving and graft through sleeve ACL reconstruction group (group D). In the group A, the joint capsule was cut open without dissection of the ACL, and corresponding rabbit models were established in the other three groups. Healing conditions of the remnant and tendon graft between groups C and D were observed at 12 weeks post-surgery, and the biomechanical properties of the tendon graft were determined by the pull-off test. Cartilage degeneration was assessed by Mankin score, following hematoxylin-eosin and Masson staining of the medial tibial plateau, and chondrocyte apoptosis examined using TUNEL assay. Expression of matrix metalloproteinase 13, proteoglycan and Bax proteins was measured using western blot assay. RESULTS AND CONCLUSION: Healing of remnant to the tendon grafts was not observed in groups C and D at 12 weeks post-surgery. In addition to the presence of articular cartilage degeneration, the Mankin score, cartilage apoptotic index, and expression of matrix metalloproteinase 13 and Bax proteins in groups B, C and D were all significantly higher than those of group A (P 0.05). To conclude, there are no significant differences in articular cartilage degeneration following remnant-preserving and conventional ACL construction, and this may be associated with the absence of increased knee stability by remnant preservation.