Sundar Siva, Pendegrass Catherine J, Blunn Gordon W
Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Brockley Hill, Stanmore, Middlesex, UK.
J Biomed Mater Res B Appl Biomater. 2009 Jan;88(1):115-22. doi: 10.1002/jbm.b.31157.
Rotator cuff repair surgery has high failure rates, with tendon reattachment to bone remaining a challenging clinical problem. Increasing the integrity of the healing tendon-bone interface has been attempted by adopting a number of different augmentation strategies. Because of chondrogenic and osteogenic properties we hypothesise that demineralized bone matrix (DBM) augmentation of a healing tendon-bone interface will result in improved function, and a morphology that more closely resembles that of a normal enthesis, compared with nonaugmented controls in an ovine patellar tendon model. The right patellar tendon was detached from its insertion and reattached to an osteotomized bone bed using suture anchors. Two groups were analyzed, the control group (without augmentation) and the DBM group (DBM interposed between the tendon and bone). Animals were sacrificed at 12 weeks. Force plate, mechanical, and histomorphometric analyses were performed. Tendon repairs failed at a rate of 33 and 0% for the control and DBM groups, respectively. DBM augmentation resulted in significantly improved functional weight bearing and increased amounts of fibrocartilage and mineralized fibrocartilage. This study shows that DBM enhances tendon-bone healing and may reduce the high failure rates associated with rotator cuff repair clinically.
肩袖修复手术失败率较高，肌腱重新附着于骨骼仍是一个具有挑战性的临床问题。人们尝试通过多种不同的增强策略来提高愈合中的肌腱 - 骨界面的完整性。鉴于脱矿骨基质（DBM）具有软骨生成和成骨特性，我们推测，在绵羊髌腱模型中，与未增强的对照组相比，对愈合中的肌腱 - 骨界面进行DBM增强将改善功能，并使形态更接近正常附着点。将右髌腱从其附着处分离，使用缝合锚将其重新附着于截骨后的骨床。分析了两组，即对照组（未增强）和DBM组（在肌腱和骨骼之间插入DBM）。在12周时处死动物。进行了测力板、力学和组织形态计量学分析。对照组和DBM组的肌腱修复失败率分别为33%和0%。DBM增强导致功能负重显著改善，纤维软骨和矿化纤维软骨数量增加。这项研究表明，DBM可促进肌腱 - 骨愈合，并可能降低临床上与肩袖修复相关的高失败率。
