Comparison of two different superior capsule reconstruction methods in the treatment of chronic irreparable rotator cuff tears: a biomechanical and histologic study in rabbit models.
Comparison of two different superior capsule reconstruction methods in the treatment of chronic irreparable rotator cuff tears: a biomechanical and histologic study in rabbit models.
复制标题
两种不同的高级囊重建方法治疗慢性不可修复的肩袖撕裂的比较：兔模型的生物力学和组织学研究。
DOI：
10.1016/j.jse.2018.08.022
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发表时间：
2019
影响因子：
3
通讯作者：
E. Sünbüloğlu
中科院分区：
文献类型：
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作者：
F. Yıldız;K. Bilsel;Anıl Pulatkan;Mehmet Kapıcıoğlu;G. Uzer;Tolga Çetindamar;Cavide Sonmez;E. Bozdag;E. Sünbüloğlu
在治疗不可修复的旋转袖（RC）撕裂时，采用阔筋膜张肌（TFL）或几种同种异体移植物重建肩部上囊，以防止关节进行性退变。本研究从生物力学和组织学角度比较了脱细胞人真皮移植物（HDG）和TFL自体移植物在上囊重建（SCR）中的愈合质量。方法9只兔建立双侧快速牵张的RC撕裂模型，7只兔建立完整的RC撕裂模型作为对照组。撕裂后8周进行SCR，右肩采用HDG，左肩采用TFL。SCR术后12周，每个实验组2个肩关节进行组织学愈合检查，实验组和对照组7个肩关节进行生物力学测试。结果两组关节盂及肱骨侧均可见完全愈合。各组间端部成熟评分无差异。TFL组胶原纤维密度高，取向性好。TFL组未见炎症细胞浸润，而HDG组有明显的炎症细胞浸润。TFL组、HDG组和完整RC组的平均拔牙强度分别为139.7±40.5 N、123.9±47.9 N和105.1±11.8 N (P=；分别为187)。平均刚度值(P=。711)，屈服力(P=。404)，两组之间的位移（P= 0.135）也无统计学差异。结论在SCR兔模型中，HDG和TFL的愈合质量相似。
BackgroundIn the treatment of irreparable rotary cuff (RC) tears, the superior capsule of the shoulder is reconstructed using tensor fascia lata (TFL) or several allografts to prevent progressive joint degeneration. This study compared the healing qualities of acellular human dermal graft (HDG) and the TFL autograft in superior capsule reconstruction (SCR) from biomechanical and histologic perspectives.MethodsChronic retracted RC tear models were created bilaterally in 9 rabbits, and 7 rabbits with intact RC were used as a control group. SCR was performed 8 weeks after the tear using HDG in right shoulders and TFL in left shoulders. At 12 weeks after SCR, 2 shoulders from each experimental group were investigated for histologic healing, and 7 samples from the experimental and control groups were biomechanically tested.ResultsComplete healing was observed macroscopically in the glenoid and humeral sides of both groups. No difference was observed in the enthesis maturation scores between the experimental groups. Collagen fiber density was higher and the orientation was better in TFL group. Inflammatory cell infiltration was not seen in the TFL group, but inflammatory cell infiltration was pronounced in the HDG group. The mean pullout strengths of the TFL group, HDG group, and intact RC group were 139.7 ± 40.5 N, 123.9 ± 47.9 N, and 105.1 ± 11.8 N (P= .187), respectively. The mean stiffness values (P= .711), yield forces (P= .404), and displacements (P= .135) were also statistically not different between the groups.ConclusionIn SCR, the healing qualities of HDG and TFL were similar in rabbit models.