To research the operative method and the cl inical efficacy of repairing and reconstructing tendon and l igament with allograft tendon. Methods From September 2000 to May 2007, 164 cases with tendon and l igament injuries were treated, including 116 males and 48 females aged 21-47 years old (average 31.5 years old). There were 126 cases of anterior cruciate l igament injury, 18 cases of complete acromioclavicular dislocation, 10 cases of old dislocation of radialhead, 4 cases of Achilles tendon rupture, 2 cases of tibial is anterior muscle rupture, 2 cases of patellar tendon rupture, and 2 cases of rectus femoris rupture. Time interval between injury and hospital admission was 4-345 days (average 75 days). Allograft tendon 10-26 cm in length with suture anchor or absorbable interference screw was used to reconstruct the l igament and tendon. Results All wounds healed by first intention, except one case of rectus femoris rupture. All patients were followed for 10-36 months (average 21 months). The international knee documentation commitee and the Lysholm score of patients with anterior cruciate l igament injury 12 months after operation were significantly higher than that of before operation (P lt; 0.01). According to the Lazzcano and Karlsson score standard, 13 cases of complete acromioclavicular dislocation at 10-12 months after operation were graded as excellent and 5 cases were good. According to Arner Lindholm score standard, 3 cases of Achilles tendon rupture at 8-16 months after operation were graded as excellent and 1 case was good. For the patients with tibial is anterior muscle rupture, at 10-17 months after operation, the limitation of dorsal extension in ankle joint was 5°, and the muscle strength in the anterior tibial is muscle was decreased. For the patients with patellar tendon rupture, one completely restored the motion range of the knee joint 14 months after operation, the other had knee extension l imitation of 10° at 13 months after operation. For the patients with rectus femoris rupture, one had 15° of extension limitation at 18 months after operation, the other suffered limitation of both extension and genuflex at 12 months after operation. According to the Broberg-Morrey score standard, 7 caseswith old dislocation of radial head were graded as excellent and 3 cases were good at 3-36 months after operation. Conclusion Allograft tendon is a good material for repairing and reconstructing tendon and ligament injuries, but attention should be paid to postoperatively early exercise under appropriate protection and early management of local rejection.
Objective To clarify the trends of expression levels of several up-regulated micro RNA (miRNA) in tissues of atrophic bone nonunion and mRNAs and proteins of their related target genes in osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs), and to explore their biological functions. Methods The hBMSCs were isolated from bone marrow of il iac bone by gradient centrifugation, and cultured. Osteogenic culture medium was used for osteogenic differentiation of the 4th generation of hBMSCs. The changes of corresponding miRNAs, mRNA and protein expression levels of related target genes were observed at 0 hour, 12 hours, 1 day, 2 days, 4 days, 7 days, and 14 days, by quantitative real-time PCR and Western blot. Results In the process of hBMSCs osteogenic differentiation, the mRNA and protein expression levels of osteoblastic target genes [alkal ine phosphatase l iver/bone/kidney (ALPL), bone morphogeneticprotein 2 (BMP-2), and platelet-derived factor alpha polypeptide (PDGF-A)] at most time points increased significantly whencompared with the values at 0 hour except that of BMP-2 decreased at 12 hours and 1 day, with maximum changes at 1 to 7 days. The miRNA expression levels, mRNA and protein expression levels changed significantly at different time points, while the trends of hsa-miRNA-149 and hsa-miRNA-654-5p changes were negatively correlated with the trends of ALPL and BMP-2 mRNA and protein expression changes respectively (P lt; 0.05). There was no obviously negative correlation between the trends of hsa-miRNA-221 change and PDGF-A change (P gt; 0.05). Conclusion In the osteogenic differentiation process of hBMSCs, hsa-miRNA-149 and hsa-miRNA-654-5p are closely related with the mRNA and protein regulation of ALPL and BMP-2, respectively.