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作者：夏志林 王欣 方礼明 张树喜
【关键词】 密度
【摘要】 目的 研究人髌腱密度与其生物力学的关系,寻找能于前交叉韧带重建术前检测髌腱移植物生物力学性质的方法。方法 对20例不成对人体髌腱(男10例，女10例)进行单轴拉伸试验,来研究供者性别及髌腱密度对其生物力学性质的影响, 髌腱密度根据其所测得体积和质量计算出。结果 髌腱的生物力学性质基于性别上的差异均无显著性, 而与其密度呈正相关。密度＞1.68g/cm3(n=8)的髌腱的最大抗张强度比质量密度＜1.68g/cm3(n=12)者明显要高。结论 髌腱密度可以用来评价该髌腱的质量, 因此，可利用术前测量活体内髌腱的密度来决定该前交叉韧带重建是用异体移植物还是自体移植物。
【关键词】 髌腱；密度；移植物质量；生物力学性质
The mechanical properties of the human patellar tendon correlated to its mass density
【Abstract】 Objective To study the effects of tissue mass density on the mechanical properties of the patellar tendon and find out predictors of the mechanical properties of the patellar tendon, used as grafts in anterior cruciate ligament reconstruction surgeries.Methods Uniaxial tension tests were performed to determine the effects of donor sex and mass density of the tissue on the mechanical properties of twenty unpaired human patellar tendons(10 male and 10 female).Mass density of the patellar tendon was determined by measuring its volume and mass.Results No evidence of sex-based differences in any of the mechanical properties of the patellar tendon was found.The mechanical properties of the patellar tendon were significantly correlated to its mass density.The tensile strength were significantly higher for those patellar tendons having a mass density greater than 1.68g/cm3.Conclusion The mass density of the patellar tendon may be considered as an indicator of mechanical properties of the patellar tendon or graft quality.In vivo measurement of the mass density of the patellar tendon,prior to surgery,can be used to decide if a particular ACL reconstruction should be carried out with an allograft or an autograft.
【Key words】 patellar tendon；mass density；graft quality；mechnical properties
自体髌腱复合体曾被作为移植重建前交叉韧带的金标准，目前仍为外科医生重建手术的首选。学者们对髌腱的生物力学性质进行了广泛研究，希望找到能于移植前有效评价移植腱质量的客观变量，为临床选择肌腱提供依据。笔者对人髌腱的密度及其生物力学性质进行研究，希望确定供体髌腱密度对其生物力学性质的影响。
1 资料与方法
1.1 一般资料 从国人新鲜尸体中获取20例不成对的膝关节（男10例，女10例），冷冻在-20℃，直到试验日为止。膝关节均在供者死亡后12h内冷冻。冷冻时间1～12个月不等。死者排除以下情况：（1）年龄＞50岁；（2）骨骼未发育完全者（女性＜16岁，男性＜19岁）；（3）有膝关节手术史；（4）有膝关节炎病史。在取髌腱标本之前，先将膝关节在室温中解冻。将髌腱连同全部髌骨和胫骨的一部分（包含有胫骨结节）从膝关节中分割出来。胫骨部分修整成楔形，取髌腱的中央部分（平均5mm宽），用手术刀沿着腱束的长轴将腱的内外侧修理成直的平面。小心操作以避免将腱束横行切断。用游标卡尺在不同截面测量髌腱的宽和厚，取其均值，并测量髌腱的长，用以计算髌腱的体积。
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