Micromechanical Properties and Collagen Composition of Ruptured Human Achilles Tendon
Micromechanical Properties and Collagen Composition of Ruptured Human Achilles Tendon
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DOI：
10.1177/0363546512470617
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发表时间：
2013-02-01
影响因子：
4.8
通讯作者：
Magnusson, S. Peter
中科院分区：
文献类型：
--
作者：
Hansen, Philip;Kovanen, Vuokko;Magnusson, S. Peter
背景：跟腱是人体最坚固的肌腱之一，但它经常发生断裂，这是一个严重的临床问题。然而，断裂的原因仍然难以捉摸。假设：与未受伤的肌腱相比，断裂的人类跟腱表现出较差的生物力学特性，并且胶原蛋白成分发生改变。研究设计：对照实验室研究。方法：从 17 名急性跟腱断裂患者的断裂部位和肌腱的未受伤部分（内部对照）获取活检标本。还获得了年龄和体重匹配的人类尸体跟腱（外部对照）。对肌腱样品进行了显微机械和生物化学测试。 结果：与外部对照肌腱 (512.9 +/- 209.6 MPa；P < .01) 相比，断裂肌腱 (256.7 +/- 100.8 MPa) 和内部控制肌腱 (262.4 +/- 111.5 MPa) 的平均杨氏模量较低 (P < .01)，而失效强度没有表现出类似的差异 (P = .06-.16)。胶原含量、赖氨酰吡啶啉 (LP)、羟赖氨酰吡啶啉 (HP) 和戊糖苷 (PENT) 在断裂肌腱和未损伤肌腱之间没有表现出区域差异。然而，与外部对照肌腱 (0.585 +/- 0.044 mg/mg，P < .001) 相比，断裂肌腱 (0.457 +/- 0.093 mg/mg) 和未受伤肌腱 (0.476 +/- 0.072 mg/mg) 中的胶原蛋白含量较低。所有肌腱样本中的戊糖素相似，并且与所有样本中的年龄呈正相关（r(2) = 0.44-0.72，P < .05）。胶原蛋白含量与失效应力呈正相关，但仅在破裂样品中存在（r(2) = 0.36；P < .05）。 HP、LP 和 PENT 含量与断裂、未受伤和尸体肌腱的失效应力和杨氏模量无关。结论：这些数据表明肌腱可能存在机械弱化，胶原蛋白含量减少可能与跟腱断裂的病理生理特征有关。临床相关性：早期的研究表明，治疗肌腱损伤的特定训练方案可以改善肌腱的成分和机械性能。这项研究支持这样的观点，即治疗措施应旨在增加肌腱胶原蛋白含量并改善肌腱基质的微机械质量。
Background: The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive.Hypothesis: Ruptured human Achilles tendon displays inferior biomechanical properties and altered collagen composition compared with noninjured tendon.Study Design: Controlled laboratory study.Methods: Biopsy specimens were obtained at the rupture site and the noninjured part of the tendon (internal controls) in 17 patients with acute Achilles tendon rupture. Age- and weight-matched human cadaveric Achilles tendons (external controls) were also obtained. Tendon samples were tested micromechanically and biochemically.Results: The mean Young modulus was lower (P < .01) in ruptured (256.7 +/- 100.8 MPa) and internal control tendon (262.4 +/- 111.5 MPa) compared with external control tendon (512.9 +/- 209.6 MPa; P < .01), whereas failure strength did not display similar differences (P = .06-.16). Collagen content, lysyl pyridinoline (LP), hydroxylysyl pyridinoline (HP), and pentosidine (PENT) did not display regional differences between ruptured and noninjured tendon. However, collagen content was less in ruptured (0.457 +/- 0.093 mg/mg) and noninjured tendon (0.476 +/- 0.072 mg/mg) compared with external control tendon (0.585 +/- 0.044 mg/mg, P < .001). Pentosidine was similar in all tendon samples and was positively related to age in all samples (r(2) = 0.44-0.72, P < .05). ollagen content was positively related to failure stress but only in ruptured samples (r(2) = 0.36; P < .05). HP, LP, and PENT content were unrelated to failure stress and Young modulus in ruptured, noninjured, and cadaveric tendon.Conclusion: These data imply that there may be a mechanical weakening of the tendon and that a reduced collagen content may be related to the pathophysiological characteristics of Achilles tendon rupture. Clinical Relevance: Earlier studies have demonstrated that specific training regimens to treat tendon injury can improve tendon composition and mechanical properties. This study supports the notion that treatment measures should aim to increase tendon collagen content and improve micromechanical quality of the tendon matrix.