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前交叉韧带重建术后腱骨愈合的生物学干预
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Abstract:
前交叉韧带断裂的主要原因是运动损伤，约占70%以上。前交叉韧带损伤能够继发关节软骨退变及半月板损伤，甚至导致关节功能丧失。在关节镜下行自体腘绳肌肌腱重建前交叉韧带是目前公认最有效的治疗方式，但失败率约为0.7%~10%，其手术失败的重要原因是移植肌腱与骨隧道愈合不良导致的。前交叉韧带重建术后腱骨界面的愈合是影响手术效果和患者转归的重要因素。因此，目前迫切需要寻找有效促进腱骨愈合作用靶点和干预方法作为补充治疗措施。本文从生物学干预角度对腱骨愈合的相关研究进行综述，总结目前医学前沿的基因工程技术加速腱骨愈合的关键问题，并展望未来的应用前景，降低重建后韧带的再损伤率，快速帮助患者恢复运动功能，改善生活质量，提高生活水平。
The primary cause of anterior cruciate ligament rupture is sports-related injuries, accounting for over 70% of cases. Anterior cruciate ligament injury can lead to secondary joint cartilage degenera-tion and meniscus injury, and even result in loss of joint function. Autogenous hamstring tendon reconstruction of the anterior cruciate ligament is currently recognized as the most effective treat-ment method, but failure rates range from 0.7% to 10%. The main reason for surgical failure is poor healing between the transplanted tendon and bone tunnel. The healing of the tendon-bone inter-face after anterior cruciate ligament reconstruction surgery is an important factor affecting surgical outcomes and patient recovery. Therefore, there is an urgent need to identify effective targets and intervention methods to promote tendon-bone healing as a supplementary treatment measure. This article provides a comprehensive review of relevant research on tendon-bone healing from a biological intervention perspective, summarizes key issues in gene engineering technology at the forefront of medicine to accelerate tendon-bone healing, and looks ahead to future applications that can reduce the rate of re-injury after reconstruction, restore patients’ physical function, improve the quality of life and the standard of living.
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