用于膝关节韧带移植的材料

A. A. Budaev, M. Makarov, V. V. Slastinin, N. Borovkova
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摘要

作者提出的科学文献综述生产移植物用于韧带断裂的外科重建。在重建整形手术中,韧带断裂的治疗可采用合成移植物、自体和同种异体组织供体移植物。人工合成移植物的优点包括可以在无菌条件下常规制造,具有良好的机械性能和较高的生物相容性。然而,人工合成假体明显增加滑膜炎等并发症的风险,它们不能被天然组织替代,也没有再生能力。自体移植物具有理想的组织相容性和快速的生物融合性,可从不同的解剖部位摘取,但通常移植后存在供体部位病变和损伤神经的潜在风险,延长手术时间,美观效果差。自体移植物的使用也可能受到患者解剖特征的限制。同种异体韧带生物材料可以提供广泛的移植物,但目前尚无标准化的韧带移植物灭菌和长期保存方法。众所周知的灭菌方法,如电离辐射和化学处理,产生了有争议的结果。我们可以得出结论,对韧带移植物生存能力的评估必须包括对生物力学特性、细胞和纤维完整性的复杂研究。
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Materials used for knee ligament grafting
The authors have presented the review of scientific literature on producing grafts intended for surgical reconstruction of ligament ruptures. The treatment of ligament ruptures in reconstructive plastic surgery could be performed by using synthetic grafts, autologous and allogenic grafts from tissue donors. Advantages of synthetic grafts include the possibility of their regular manufacturing under sterile conditions, and providing mechanical properties, high biocompatibility. However, synthetic implants significantly increase the risk of synovitis and other complications, they can not be replaced by the native tissue, and have no ability to regeneration. Autologous grafts have ideal tissue compatibility and quick biointegration, could be harvested from different anatomical sites, but commonly the graft harvesting is followed by donor site morbidity and potential risk of injury nerves, elongates operation time, bad cosmetic results. The use of autografts may be also limited by anatomical features of the patient. Allogenic ligament biomaterial could provide wide range of grafts, but in our days there is no standardized methods for ligament graft sterilization and long storage. Wellknown sterilization methods, such as ionized radiation and chemical treatment, gave controversial results. One could conclude that estimation of ligament graft viability must include a complex study of biomechanical properties, cell and fibers integrity.
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