Aneja Arun, Karas Spero G, Weinhold Paul S, Afshari Hessam M, Dahners Laurence E
Department of Orthopaedics, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
Am J Sports Med. 2005 Nov;33(11):1729-34. doi: 10.1177/0363546505275492. Epub 2005 Aug 10.
Shortening or tightening of dense, collagenous tissues is often desirable in the treatment of laxity.
To compare the effect of stress-protection suture, radiofrequency thermal shrinkage combined with stress-protection suture, and a 5% sodium morrhuate sclerosing injection on the length and biomechanical strength of the rat patellar tendon.
Sclerosing agents will increase tendon mechanical strength. Thermal shrinkage combined with stress-protection suture and stress-protection suture only will cause a short-term decrease in tendon strength. All 3 methods will produce equivalent shortening of the tendon.
Controlled laboratory study.
Forty-six female retired breeder rats were split into 4 groups, each receiving 1 of the 3 aforementioned treatments plus a control group that received a saline injection. After 4 weeks' survival, the length and biomechanical properties of the patellar tendons were measured and compared to the contralateral untreated tendon.
Rats treated with stress-protection suture had shorter tendons. Radiofrequency thermal shrinkage combined with stress-protection suture yielded tendons that were both shorter and stronger than were the untreated contralateral tendons. The sodium morrhuate-injected tendons were stronger whereas the saline-treated tendons were weaker than were their respective untreated contralateral tendons.
Surgical stress-protection suture without radiofrequency shrinkage is most effective at shortening the length of the rat patellar tendon, whereas radiofrequency thermal shrinkage combined with stress-protection suture as well as sodium morrhuate are effective at increasing the strength of rat patellar tendons.
Judicious use of thermal shrinkage in combination with stress protection may improve ligament strength and decrease laxity.
在治疗组织松弛时，通常希望缩短或收紧致密的胶原组织。
比较应力保护缝线、射频热缩联合应力保护缝线以及5%鱼肝油酸钠硬化剂注射对大鼠髌腱长度和生物力学强度的影响。
硬化剂会增加肌腱的机械强度。热缩联合应力保护缝线以及单纯应力保护缝线会导致肌腱强度短期内下降。三种方法都会使肌腱产生同等程度的缩短。
对照实验室研究。
将46只雌性退休繁殖大鼠分为4组，每组接受上述三种治疗中的一种，外加一个接受生理盐水注射的对照组。存活4周后，测量髌腱的长度和生物力学特性，并与对侧未治疗的肌腱进行比较。
接受应力保护缝线治疗的大鼠肌腱较短。射频热缩联合应力保护缝线处理后的肌腱比未治疗的对侧肌腱更短且更强。注射鱼肝油酸钠的肌腱更强，而注射生理盐水的肌腱比各自未治疗的对侧肌腱更弱。
不进行射频收缩的手术应力保护缝线在缩短大鼠髌腱长度方面最有效，而射频热缩联合应力保护缝线以及鱼肝油酸钠在增加大鼠髌腱强度方面有效。
明智地使用热缩联合应力保护可能会提高韧带强度并减少松弛。
