摘要：
Objective To investigate the changes of mechanoreceptors in the different state remnant stumps after anterior cruciate ligament(ACL)rupture.Methods From March 2013 to December 2015,fifty-seven cases of complete ACL rupture were collected to record the time interval from injury to surgery.The patients were divided into two groups according to preoperative kneelax joint measurement results:≤6 mm group (group 1)and>6 mm group(group 2).The morphology of each ligament stump in the two groups was recorded.After H&E staining and immunohistochemical labeling,the morphology,type,and quantity of the mechanoreceptors in the ligament stump were observed under an optical microscope.The relationship among the changes of the mechanoreceptors in the remnant stumps and the morphology of the ligament stump,the affected knee stability and the time from injury to surgery were analyzed.Results Twenty specimens were included in group 1.While 37 specimens were included in group 2.There was significant difference between the two groups in the distributions of the 4 types of the remnant stumps(P=0.000).There was significant difference between the two groups in the distributions of the 4 types of mechanoreceptors(P= 0.002).The number of the mechanoreceptors was positively correlated with the affected knee stability(r=0.63,P=0.018).There was no significant correlation between the number of the mechanoreceptors and the time from injury to surgery in group1 (r=-0.37,P=0.136),while the number of the mechanoreceptors was negatively correlated with the time from injury to surgery in group 2(r=-0.51,P =0.022).Conclusion After ACL rupture,the ligament stump in some patients still connect the femur and the tibia in the joint cavity,and exert mechanical stability function, which can retain the mechanoreceptors in the tissue for a long time.%目的 观察人体前交叉韧带(anterior cruciate ligament,ACL)断裂后不同状态韧带残端内机械感受器随时间的变化.方法 收集我院2013年3月至2015年12月收治的临床上ACL完全断裂患者韧带残端标本57例,记录受伤到手术的时间间隔,根据术前kneelax关节动度测量仪测量结果分成两组:≤6 mm组(组1)和>6 mm组(组2),记录两组每个韧带残端形态类型,切除韧带残端组织进行H&E染色和免疫组化染色,观察韧带残端内本体感受器形态、类型、数量的变化,分析韧带残端内本体感受器的变化与韧带残端形态、患膝稳定性及手术时间的关系.结果 组1包括韧带标本20例,组2包括韧带标本37例.两组间4种形态残端分布差异有统计学意义(P=0.000),两组间4种机械感受器分布差异有统计学意义(P=0.002).机械感受器数量与膝关节稳定性呈正相关(r=0.63,P=0.018).组1内机械感受器数量与受伤时间无明显相关(r=-0.37,P=0.136),组2内机械感受器数量与受伤时间呈负相关(r=-0.51,P=0.022).结论 ACL断裂后,部分患者韧带残端仍然在关节腔内连接股骨和胫骨,并发挥力学稳定功能,从而可以长时间的保留住组织内的机械感受器.
