Rotator cuff tendon to bone insertion site healing

肩袖肌腱至骨插入部位愈合

• 批准号: 7282128
• 负责人: GERALD R WILLIAMS
• 金额: $ 2.88万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7282128
• 关键词: Rotator; cuff; tendon; bone; insertion

DESCRIPTION (provided by applicant): The ability of rotator cuff tendons to heal back to bone following injury is limited and incomplete healing of surgically repaired rotator cuff tears in humans has been reported in 20-70% of cases. Many factors outside of the surgeon's control contribute to the limited healing potential including patient age, tear size, and time from injury to repair. However, two important factors that are within the surgeon's control are surgical repair technique and post-operative rehabilitation protocol. Much research has been done on surgical repair technique including studies related to repair approach, strength of suturing methods, and security of anchoring techniques. Surprisingly, while post-operative rehabilitation protocols are generally understood to have a great influence on the fundamental mechanisms of the healing process and on the resulting function, very little data is available on this topic to guide the clinician. As a result, most post-operative protocols are based on anecdotal experiences of particular clinicians. In a recent study in our laboratory, we developed an animal model in which the healing of the rotator cuff tendon to bone insertion site could be carefully evaluated. Using this model, the overall objective of the current study is to investigate the healing process of the rotator cuff tendon to bone insertion site subject to immobilization and remobilization. Biomechanical and structural properties will be measured to evaluate the effect of the post-operative protocol on healing. In addition, histologic and molecular biologic assessments will be performed to begin to elucidate the mechanisms through which biomechanical and structural properties were altered. The Specific Aims are: (1) following tendon to bone insertion site injury and repair, vary the immobilization period for a given set of remobilization period. (2) Following tendon to bone insertion site injury and repair, vary the remobilization period for a given set of immobilization period. We believe that a long remobilization period, following a sufficient immobilization period, will allow adequate integration of tendon fibers into bone and expression of appropriate ECM proteins to re-form the insertion site resulting in an insertion site with improved mechanical properties and more aligned collagen fibers.

描述（由申请人提供）：肩袖肌腱在受伤后愈合回骨头的能力是有限的，据报道，在人类手术修复的肩袖撕裂中，有 20-70% 的病例愈合不完全。外科医生无法控制的许多因素都会导致愈合潜力有限，包括患者年龄、撕裂大小以及从受伤到修复的时间。然而，外科医生可以控制的两个重要因素是手术修复技术和术后康复方案。人们对手术修复技术进行了大量的研究，包括与修复方法、缝合方法的强度和锚定技术的安全性相关的研究。令人惊讶的是，虽然人们普遍认为术后康复方案对愈合过程的基本机制和最终的功能有很大影响，但关于这一主题可用于指导临床医生的数据却很少。因此，大多数术后方案都是基于特定临床医生的轶事经验。在我们实验室最近的一项研究中，我们开发了一种动物模型，可以仔细评估肩袖肌腱到骨插入部位的愈合情况。使用该模型，当前研究的总体目标是研究肩袖肌腱到骨插入部位的固定和再活动的愈合过程。将测量生物力学和结构特性，以评估术后方案对愈合的影响。此外，还将进行组织学和分子生物学评估，以开始阐明生物力学和结构特性改变的机制。具体目标是：（1）在肌腱到骨插入部位损伤和修复之后，改变给定的一组再活动期的固定期。 (2) 在肌腱到骨插入部位损伤和修复之后，改变给定的一组固定期的再活动期。我们相信，在足够的固定期之后，较长的再活动期将使肌腱纤维充分整合到骨骼中，并表达适当的 ECM 蛋白以重新形成插入位点，从而导致插入位点具有改善的机械性能和更对齐的胶原纤维。