Evaluation of in Vivo Rotator Cuff Muscle Function After Acute and Chronic Detachment of the Supraspinatus Tendon
Evaluation of in Vivo Rotator Cuff Muscle Function After Acute and Chronic Detachment of the Supraspinatus Tendon
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DOI：
10.2106/jbjs.j.00184
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发表时间：
2011-09-21
影响因子：
5.3
通讯作者：
Tuohy, Christopher J.
中科院分区：
文献类型：
--
作者：
Mannava, Sandeep;Plate, Johannes F.;Tuohy, Christopher J.
背景：大型慢性肩袖撕裂的手术修复在技术上有很高的要求，因为它需要对肌肉肌腱单元进行操作，这些肌肉肌腱单元有疤痕、收缩和比正常情况更硬，所有这些都会导致修复部位的张力增加。本研究的目的是描述在手术相关的预负荷张力下急性和慢性损伤后的体内肩袖肌肉-肌腱单位功能。方法：将62只Sprague-Dawley大鼠分为健康未损伤组（对照组）22只、急性损伤组（急性损伤组）20只和慢性损伤组（慢性损伤组）20只，分别进行不同负荷张力下冈上肌-肌腱单元的体内肌力测试和肌电图测试。结果：预负荷张力影响各组冈上肌最大收缩力（p < 0.05）。在修复急性撕裂所需的张力峰值处，各组最大破伤风收缩幅度降低28% ~ 30% （p < 0.05）。在修复慢性撕裂所需的峰值张力处，所有组的最大破伤风收缩幅度降低了40% ~ 53% （p < 0.05）。与急性损伤组和慢性损伤组相比，未损伤组在所有预负荷张力下的肌肉耐力均有所增加（p < 0.05）。慢性损伤组大鼠复合动作电位幅值降低（p < 0.05）。结论：急性和慢性损伤组均表现出与负荷前张力增加有关的功能损伤。较高的修复张力，与慢性损伤相关，导致更大的功能损伤。本研究还证明了肩袖肌腱损伤时间的增加与体内肩袖肌肌电图结果受损之间的关联。
Background: Surgical repair of large chronic rotator cuff tears can be technically demanding because it requires manipulation of a muscle-tendon unit that is scarred, retracted, and stiffer than normal, all of which contribute to increased tension at the repair site. The purpose of the present study was to characterize the in vivo rotator cuff muscle-tendon unit function after acute and chronic injury at surgically relevant preload tensions.Methods: Sixty-two Sprague-Dawley rats were divided into a healthy, uninjured (control) group (n = 22), an acute injury group (n = 20), and a chronic injury group (n = 20) and underwent in vivo muscle force testing and electromyographic testing of the supraspinatus muscle-tendon unit at various preload tensions.Results: Preload tension affected the maximum supraspinatus muscle contractile force in all groups (p < 0.05). At the peak tension required to repair an acute tear, there was a 28% to 30% reduction in maximum tetanic contraction amplitude in all groups (p < 0.05). At the peak tension required to repair a chronic tear, there was a 40% to 53% reduction in maximal tetanic contraction amplitude in all groups (p < 0.05). The uninjured (control) group showed increased muscle endurance (p < 0.05) in comparison with the acute injury and chronic injury groups at all preload tensions. The chronic injury group showed reduced compound motor action potential amplitude (p < 0.05).Conclusions: Both the acute and chronic injury groups demonstrated functional impairment related to increasing preload tensions. Higher repair tensions, associated with the chronic injury setting, resulted in greater functional impairment. The present study also demonstrates an association between increased time from rotator cuff tendon injury and impaired in vivo rotator cuff muscle electromyographic findings.