Achilles Tendon Injuries: A Comparison of Surgical Repair Versus No Repair in a Rat Model ∗
Achilles Tendon Injuries: A Comparison of Surgical Repair Versus No Repair in a Rat Model ∗
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跟腱损伤：大鼠模型中手术修复与不修复的比较*
DOI：
10.1177/107110079301400706
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发表时间：
1993
影响因子：
2.7
通讯作者：
T. Best
中科院分区：
文献类型：
--
作者：
G. C. Murrell;E. Lilly;Alison Collins;A. Seaber;R. Goldner;T. Best
关于跟腱断裂的治疗存在争议。本研究的目的是确定大鼠跟腱的手术修复是否比不修复具有生物力学、功能或形态学优势。将 32 只雄性 Sprague-Dawley 大鼠随机分为四组：（1）假手术（仅切开皮肤），（2）不修复（跟腱和跖肌腱完全分开，无需修复），（3）内夹板（跖肌保持完整），（4）跟腱修复（使用改良的凯斯勒型缝合线）。功能表现是通过利用跟腱功能指数测量后爪印来确定的。第15天，处死动物，并对受伤和未受伤的跟腱结构进行生物力学和组织学评估。所有接受跟腱分裂的组均具有显着的初始功能损伤，随后逐渐改善，因此到第 15 天，任何组均未出现功能或失效负荷损伤。第 15 天，所有三组接受跟腱分割的受伤肌腱的横截面积都增加了 13 倍，并且比未受伤和假手术肌腱的硬度更小，变形更大 (P < .001)。对于不修复组、内夹板组和跟腱修复组，术后第 15 天生物力学和形态学变化的程度以及初始损伤和功能恢复率相似。总之，这项研究表明，大鼠跟腱的手术修复并不比非手术治疗有任何优势。
Controversy exists regarding the treatment of Achilles tendon ruptures. The aim of this study was to determine whether surgical repair of the rat Achilles tendon offered any biomechanical, functional, or morphological advantage over no repair. Thirty-two male Sprague-Dawley rats were randomly allocated into four groups: (1) sham operated (skin incision only), (2) no repair (complete division of the Achilles tendon and plantaris tendon without repair), (3) internal splint (plantaris left intact), and (4) Achilles repair (with a modified Kessler-type suture). Functional performance was determined from the measurements of hindpaw prints utilizing the Achilles Functional Index. On day 15, the animals were killed, and biomechanical and histological evaluations were performed on both the injured and uninjured Achilles tendon constructs. All groups subjected to Achilles tendon division had a significant initial functional impairment that gradually improved so that by day 15 there were no functional or failure load impairments in any group. The injured tendons in all three groups subjected to Achilles tendon division had a 13-fold increase in the cross-sectional area and were less stiff and more deformable than uninjured and sham-operated tendons on day 15 (P < .001). The magnitude of the biomechanical and morphological changes at postoperative day 15 and the initial impairment and rate of functional recovery were similar for no repair, internal splint, and Achilles repair groups. In summary, this study demonstrates that surgical repair of the Achilles tendon in the rat does not offer any advantage over nonoperative management.