Inhomogeneous mechanical behavior of the human supraspinatus tendon under uniaxial loading
Inhomogeneous mechanical behavior of the human supraspinatus tendon under uniaxial loading
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DOI：
10.1016/j.orthres.2004.02.016
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发表时间：
2005-07-01
影响因子：
2.8
通讯作者：
Flatow, EL
中科院分区：
文献类型：
--
作者：
Huang, CY;Wang, VM;Flatow, EL
肩袖的疾病，特别是肩袖肌腱的撕裂，会导致严重的肩部残疾。在许多被认为是冈上肌撕裂发生和发展的因素中，与肌腱的生物力学特性有关的因素。我们假设冈上肌腱受拉伸载荷时，在关节和法氏囊肌腱表面之间存在应变梯度（差异），这两个肌腱表面均存在区域应变差异，并且肌腱表面应变随肱骨外展而变化。为了验证这些假设，我们使用一种新型的多应变测量系统，研究了8条完整的人尸体冈上肌肌腱在三个盂肱外展角下的关节和法囊表面的固有不均匀变形特征，该系统同时记录了两个相对软组织表面的表面标记位移。在施加拉伸载荷下，关节表面在22度（7.4 +/- 2.6% vs. 1.3 +/- 0.7%, p = 0.0002）和63度（6.4 +/- 1.6% vs. 2.7 +/- 1.2%, p = 0.0001）表现出更大的应变，而法氏囊表面在90度表现出更大的应变（7.6 +/- 2.8% vs. 4.9 +/- 0.4%, p = 0.013）。在所有外展角度，止点应变均高于中肌腱和肌腱-肌肉交界区。完整冈上肌腱存在不均匀表面应变，表明腱内发生腱内剪切。肌腱关节侧的高应变，特别是在止点区域，表明撕裂倾向于在关节肌腱区开始。(c) 2004年骨科研究学会。Elsevier Ltd.出版。版权所有。
Disorders of the rotator cuff, particularly tears of the rotator cuff tendons, cause significant shoulder disability. Among numerous factors thought to be responsible for the initiation and progression of supraspinatus tears are those related to the tendon's biomechanical properties. We hypothesized that in supraspinatus tendons subjected to tensile loading a strain gradient (difference) exists between the articular and bursal tendon surfaces, that regional strain differences exist on each of these two tendon surfaces, and that tendon surface strains vary with glenohumeral abduction. To test these hypotheses, the intrinsic inhomogeneous deformational characteristics of the articular and bursal surfaces of eight intact human cadaveric supraspinatus tendons were studied at three glenohumeral abduction angles using a novel multiple strain measuring system which simultaneously recorded surface marker displacements on two opposing soft tissue surfaces. Under applied tensile loads, the articular surface exhibited greater strain at 22 (7.4 +/- 2.6% vs. 1.3 +/- 0.7%, p = 0.0002) and 63 degrees (6.4 +/- 1.6% vs. 2.7 +/- 1.2%, p = 0.0001) whereas the bursal surface exhibited greater strain at 90 (7.6 +/- 2.8% vs. 4.9 +/- 0.4%, p = 0.013). At all abduction angles, insertion strains were higher than those of the mid-tendon and tendon-muscle junction regions. The existence of inhomogeneous surface strains in the intact supraspinatus tendon demonstrates that intratendinous shear occurs within the tendon. The higher strain on the articular side of the tendon, especially at the insertion region, suggests a propensity for tears to initiate in the articular tendinous zone. (c) 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.