Rotator cuff defect healing: A biomechanical and histologic analysis in an animal model
Rotator cuff defect healing: A biomechanical and histologic analysis in an animal model
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DOI：
10.1016/s1058-2746(98)90007-6
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发表时间：
1998-11-01
影响因子：
3
通讯作者：
Soslowsky, LJ
中科院分区：
文献类型：
--
作者：
Carpenter, JE;Thomopoulos, S;Soslowsky, LJ
肩袖撕裂是上肢疼痛和残疾的最常见原因之一。通过使用动物模型，我们研究了正常冈上肌腱和内在愈合能力降低的肌腱的受控缺损的愈合反应。在36只Sprague-Dawley大鼠中，在双侧冈上肌腱中创建缺损（2 mm x 2 mml）。为了模拟具有固有降低的愈合能力的肌腱，用原位冷冻处理左肩中的缺损区域附近的组织。对侧肌腱未冻结。在3（n = 12）、6（n = 12）和12（n = 12）周后，处死动物并进行组织学（每组n = 4）和生物力学（每组n = 8）评价。另一组未给药动物作为正常对照组。在组织学评价中，78%的肌腱存在持续性缺损（定义为缺损部位闭合不完全）。随着时间的推移，两组的组织表现出改善的组织学分级，但即使在12周时也没有达到正常水平。在正常肌腱和原位冷冻治疗的肌腱缺损愈合之间没有发现组织学差异。在生物力学评价方面，治疗组之间也没有显著差异。随着时间的推移，组织性能得到改善，表明缺损部分愈合。然而，这些组织特性仍然比正常对照肌腱低一个数量级。这些研究结果表明，有一个积极的，但不充分的修复反应的缺陷，在大鼠冈上肌腱，这是没有显着恶化的原位冷冻周围的组织缺陷。该模型可用于研究改善或加速袖带缺损愈合的技术。
Rotator cuff tears are one of the most common causes of pain and disability in the upper extremity With the use of an animal model, we studied the healing response of a controlled defect in the normal supraspinatus tendon and in a tendon with a reduced intrinsic healing capacity. In 36 Sprague-Dawley rats, defects (2 mm x 2 mml were created in the supraspinatus tendons bilaterally. To model a tendon with an intrinsically reduced capacity to heal, the tissue adjacent to the defect area in the left shoulder was treated with in situ freezing. The contralateral tendon was not frozen. After 3 (n = 12), 6 (n = 12), and 12 (n = 12) weeks, animals were killed and underwent histologic (n = 4 from each group) and biomechanical (n = 8 from each group) evaluation. An additional group of untreated animals served as a normal control group. On histologic evaluation 78% of tendons had persistent defects (defined as incomplete closure of the defect site). Over time, the tissue from both groups demonstrated an improved histologic grade but did not reach normal levels, even at 12 weeks. No histologic differences were found between defect healing in normal tendons and in those treated with in situ freezing. On biomechanical evaluation there were also no significant differences between treatment groups. Over time, an improvement occurred in tissue properties, indicating that some healing of the defects had occurred. However, these tissue properties remained an order of magnitude lower than those of normal control tendons. These findings indicate that there is an active but inadequate repair response to the defect in the rat supraspinatus tendon, which is not significantly worsened by in situ freezing of the tissue around the defect. This model has applications toward the study of techniques to improve or accelerate cuff defect healing.