Achilles tendon rupture: experimental results on spontaneous repair in a sheep-model
Achilles tendon rupture: experimental results on spontaneous repair in a sheep-model
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DOI：
10.1007/s001670000149
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发表时间：
2000-11-01
影响因子：
3.8
通讯作者：
Plitz, W
中科院分区：
文献类型：
--
作者：
Bruns, J;Kampen, J;Plitz, W
用组织学和生物力学方法研究了绵羊跟腱横断和部分切除后的自愈过程。在18只用于另一动物研究的绵羊中，手术后的膝关节必须被排除在承重范围之外；因此，跟腱被切断，并在肌腱中间物质部分切除1.5厘米。将这些自愈肌腱(n=18)与健侧肌腱(n=18)进行比较。分别于术后3、6、12个月对标本进行组织学、偏振光、血管造影术，并对其抗拉强度和绝对抗拉强度进行力学分析。我们发现，在所有动物中，切除的肌腱都会自动愈合。术后至少6周，所有动物均表现出正常步态。组织学上，3个月后愈合的肌腱区域显示为纤维状的胶原组织，纤维取向疏松。横截面积在3个月时达到最大值，以后逐渐减小。同时，随着时间的推移，肌腱的纤维取向逐渐改善，12个月后，标本显示愈合后肌腱的组织学结构接近正常。生物力学方面，3个月(相当于正常肌腱的28.8%)和6个月(30.2%)标本的特异性断裂闹剧较低，而12个月后(56.7%)则有所增加。肌腱自然愈合后3个月、6个月、12个月断裂力的下降幅度较小(分别为75.6%、56.1%、81.18%)，其差异有统计学意义(P<0.05)。
We studied the course of spontaneous healing of Achilles tendons in a sheep model after transection and partial resection of the tendon by means of histological and biomechanical analyses. In 18 sheep used for another animal study the operated knee had to be excluded from weight-bearing; therefore the Achilles tendons were transected and for 1.5 cm partially resected in the middle substance of the tendon. For evaluation these spontaneously healed tendons (n=18) were compared with the contralateral noninvolved tendons (n=18). Specimens were analyzed 3, 6, and 12 months postoperatively by means of histology, polarized light, angiography, and mechanically analyzing the specific tensile strength and absolute tensile strength. We found that in all animals the resected tendon healed spontaneously. All animals exhibited a normal gait pattern at least 6 weeks postoperatively. Histologically, the tendinous area of healing demonstrated after 3 months a fibrous collagenous tissue with a loose fiber orientation. The cross-sectional area had at 3 months increased to maximum but decreased later. Concomitantly the fiber orientation improved with time and 12 months after transection the specimens showed a nearly normal histological structure of the healed tendon. Biomechanically the specimens exhibited a rather low specific rupture farce after 3 months (28.8% of normal tendons) and 6 months (30.2%) but increased after 12 months (56.7%). In regard to the resulting total rupture force the decrease in the spontaneously healed tendons was less (75.6% after 3 months, 56.1% after 6 months, 81.18% after 12 months), because the cross-sectional area of the healing tendon had significantly (P