Degenerated coracoacromial ligament in shoulders with rotator cuff tears shows higher elastic modulus: measurement with scanning acoustic microscopy
Degenerated coracoacromial ligament in shoulders with rotator cuff tears shows higher elastic modulus: measurement with scanning acoustic microscopy
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DOI：
10.1007/s00776-008-1283-x
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发表时间：
2009-01-01
影响因子：
1.7
通讯作者：
Itoi, Eiji
中科院分区：
文献类型：
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作者：
Kijima, Hiroaki;Minagawa, Hiroshi;Itoi, Eiji
本研究的目的是确定肩肩喙峰韧带的弹性，有无肩袖撕裂。20例尸体肩部（患者平均年龄79.5岁，男性8例，女性12例）的喙峰韧带分为6个部分，其中3个部分（肩峰、中央和喙峰）分为两层（浅层和深层）。总共研究了120个样本。首先，根据胶原纤维的取向将样品分为三种变性模式：波浪形、直线型和不规则型。对于每种模式，用扫描声学显微镜测量了与弹性呈正相关的组织声速。接下来，将样本分为三组：60例肩袖撕裂肩部样本（随机对照组），30例肩袖完整且肩峰下骨刺肩部样本（骨刺组），30例肩袖完整且无肩峰下骨刺肩部样本（对照组）。所有肩袖撕裂者均有肩峰下刺。比较各组组织声速及组织学表现。波浪形、直线型和不规则型声速分别为1592 +/- 17.2 m/s（平均值+/- SD）、1626 +/- 28.0 m/s和1607 +/- 29.8 m/s （P < 0.0001）。直线型声速高于波浪型声速（P < 0.0001），不规则型声速低于直线型声速（P = 0.0023）。与对照组相比，RCT组和鞭毛组有更多的直纹（P = 0.0002）和更少的波浪纹（P < 0.0001）。各组间的声速差异有统计学意义（P < 0.0001）：对照组为1596 +/- 19.1 m/s，鞭骨组为1630 +/- 31.5 m/s，随机对照组为1612 +/- 28.6 m/s。肩袖撕裂的喙肩峰韧带由于韧带退行性变，其弹性模量比年龄匹配的正常肩部高。
The purpose of this study was to determine the elasticity of the coracoacromial ligament in shoulders with and without rotator cuff tears.The coracoacromial ligaments from 20 cadaveric shoulders (average patient age 79.5 years; 8 men, 12 women) were divided into six portions - three portions (acromial, central, and coracoid) in two layers (superficial and deep). A total of 120 samples were studied. First, the samples were classified by the collagen fiber orientation into three degeneration patterns: wavy, straight, irregular. For each pattern, the tissue sound speed, which shows a positive correlation with elasticity, was measured with scanning acoustic microscopy. Next, the samples were divided into three groups: 60 samples from shoulders with rotator cuff tears (RCT group), 30 samples from shoulders with an intact rotator cuff and a subacromial spur (spur group), and 30 samples from shoulders with an intact rotator cuff without a subacromial spur (control group). All shoulders with rotator cuff tears had subacromial spurs. The tissue sound speed and the histological findings were compared among the groups.The sound speeds in the wavy, straight, and irregular patterns were 1592 +/- 17.2 m/s (mean +/- SD), 1626 +/- 28.0 m/s, and 1607 +/- 29.8 m/s, respectively (P < 0.0001). The sound speed in the straight pattern was higher than that in the wavy pattern (P < 0.0001), and that in the irregular pattern was lower than that in the straight pattern (P = 0.0023). The RCT group and the spur group had more straight patterns (P = 0.0002) and fewer wavy patterns (P < 0.0001) than did the control group. Significant differences in the sound speed were observed between the groups (P < 0.0001): 1596 +/- 19.1 m/s in the control group, 1630 +/- 31.5 m/s in the spur group, 1612 +/- 28.6 m/s in the RCT group.The coracoacromial ligament in shoulders with rotator cuff tears shows higher elastic modulus than in age-matched normal shoulders due to degeneration of the ligament.