Badhe Sachin P, Lawrence Tom M, Smith F D, Lunn P G
Department of Trauma and Orthopaedic Surgery, Derbyshire Royal Hospital, Derby, United Kingdom.
J Shoulder Elbow Surg. 2008 Jan-Feb;17(1 Suppl):35S-39S. doi: 10.1016/j.jse.2007.08.005.
Porcine dermal collagen (Zimmer Patch, formerly known as Permacol; Tissue Science Laboratories plc, Aldershot, Hampshire, UK) has been used for reinforcement of several human body tissues with success and has been shown to act as a durable, permanent tissue scaffold that assists healing. The purpose of this study was to determine the effectiveness of porcine dermal collagen as a tendon augmentation graft in the repair of extensive rotator cuff tears. This prospective study evaluated the clinical, ultrasound, and magnetic resonance imaging outcome 4.5 years (range, 3-5 years) after the treatment of extensive rotator cuff tears with porcine dermal collagen tendon augmentation grafting. The study group consisted of 10 patients (5 men, 5 women) with a mean age of 66 years (range, 46-80 years). Patients were evaluated clinically using the Constant score preoperatively, at 1 year, and at final follow-up when ultrasound and magnetic resonance imaging scans were performed to assess for graft and rotator cuff integrity. Average Constant scores improved from 41 preoperatively to 62 at final follow-up (P = .0003). Pain, abduction power, and range of motion significantly improved after surgery (P < .05), and patient satisfaction levels were high. Imaging studies identified intact grafts in 8 patients and graft detachment in 2. No adverse side effects were reported during the study period. The use of porcine dermal collagen as an augmentation graft in the treatment of massive rotator cuff tears is safe and, in most patients, is associated with improved clinical outcome. Randomized trials are required to assess any benefit over standard current surgical treatment regimens.
猪真皮胶原蛋白（齐默贴片，原名Permacol；组织科学实验室有限公司，英国汉普郡奥尔德肖特）已成功用于增强多种人体组织，并已被证明可作为一种持久的永久性组织支架来辅助愈合。本研究的目的是确定猪真皮胶原蛋白作为肌腱增强移植物在修复广泛的肩袖撕裂中的有效性。这项前瞻性研究评估了用猪真皮胶原蛋白肌腱增强移植治疗广泛肩袖撕裂4.5年（范围3 - 5年）后的临床、超声和磁共振成像结果。研究组由10名患者（5名男性，5名女性）组成，平均年龄66岁（范围46 - 80岁）。术前、1年时以及最终随访时使用Constant评分对患者进行临床评估，此时进行超声和磁共振成像扫描以评估移植物和肩袖的完整性。平均Constant评分从术前的41分提高到最终随访时的62分（P = .0003）。术后疼痛、外展力量和活动范围显著改善（P < .05），患者满意度较高。影像学研究发现8例患者移植物完整，2例患者移植物脱离。研究期间未报告不良副作用。使用猪真皮胶原蛋白作为增强移植物治疗巨大肩袖撕裂是安全的，并且在大多数患者中，与改善的临床结果相关。需要进行随机试验来评估相对于当前标准手术治疗方案的任何益处。
