Rotator cuff repair with a tendon-fibrocartilage-bone composite bridging patch.
Rotator cuff repair with a tendon-fibrocartilage-bone composite bridging patch.
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DOI：
10.1016/j.clinbiomech.2015.06.020
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发表时间：
2015-11
期刊：
影响因子：
--
通讯作者：
Zhao C
中科院分区：
文献类型：
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作者：
Ji X;Chen Q;Thoreson AR;Qu J;An KN;Amadio PC;Steinmann SP;Zhao C
在体外犬模型中比较采用新型肌腱-纤维软骨-骨复合桥接补片与传统Mason-Allen修复术修复肩袖的力学性能。从髌腱上取下20个肩关节和10个桥接补片。将贴片修剪并切成2层。在每个肩部创建冈下肌肌腱撕裂。使用改良Mason-Allen缝线修复冈下肌腱至大结节，使用或不使用桥接补片（分别为桥接补片组和对照组）。肩关节在位移控制下以0.5 mm/s的速率加载至失效。桥接补片组的极限拉伸载荷显著高于对照组（平均值[SD]，365.46 [36.45] vs 272.79 [48.88] N; P<.001）。大结节修复部位和补片-冈下肌腱修复部位的刚度显著高于对照修复部位（分别为93.96 [27.72] vs 42.62 [17.48] N/mm P<0.001; 65.94 [24.51] vs 42.62 [17.48] N/mm P= 0.02）。在犬模型中，与传统修复相比，肌腱-纤维软骨-骨复合桥接补片在补片-大结节修复部位实现了更高的极限拉伸载荷和刚度。这种复合组织将传统的肌腱-骨愈合界面（具有不同的组织）转化为一对骨-骨和肌腱-肌腱界面，这可以提高愈合质量并降低再撕裂率。
To compare the mechanical performance of a rotator cuff repaired with a novel tendon-fibrocartilage-bone composite bridging patch vs the traditional Mason-Allen repair in an in vitro canine model. Twenty shoulders and 10 bridging patches from patellar tendon were harvested. The patches were trimmed and sliced into 2 layers. An infraspinatus tendon tear was created in each shoulder. Modified Mason-Allen sutures were used to repair the infraspinatus tendon to the greater tuberosity, with or without the bridging patch (bridging patch group and controls, respectively). Shoulders were loaded to failure under displacement control at a rate of 0.5mm/sec. The ultimate tensile load was significantly higher in the bridging patch group than control (mean [SD], 365.46 [36.45] vs 272.79 [48.88] N; P<.001). Stiffness at the greater tuberosity repair site and the patch-infraspinatus tendon repair site was significantly higher than the control repair site (93.96 [27.72] vs 42.62 [17.48] N/mm P<.001; 65.94 [24.51] vs 42.62 [17.48] N/mm P=.02, respectively). The tendon-fibrocartilage-bone composite bridging patch achieved higher ultimate tensile load and stiffness at the patch–greater tuberosity repair site compared with traditional repair in a canine model. This composite tissue transforms the traditional tendon-to-bone healing interface (with dissimilar tissues) into a pair of bone-to-bone and tendon-to-tendon interfaces, which may improve healing quality and reduce retear rate.