Peltz Cathryn D, Perry Stephanie M, Getz Charles L, Soslowsky Louis J
McKay Orthopaedic Research Laboratory, University of Pennsylvania, 424 Stemmler Hall, 36th and Hamilton Walk, Philadelphia, Pennsylvania 19104, USA.
J Orthop Res. 2009 Mar;27(3):416-20. doi: 10.1002/jor.20770.
Rotator cuff tears are disabling conditions that result in changes in joint loading and functional deficiencies. Clinically, damage to the long-head of the biceps tendon has been found in conjunction with rotator cuff tears, and this damage is thought to increase with increasing tear size. Despite its importance, controversy exists regarding the optimal treatment for the biceps. An animal model of this condition would allow for controlled studies to investigate the etiology of this problem and potential treatment strategies. We created rotator cuff tears in the rat model by detaching single (supraspinatus) and multiple (supraspinatus + infraspinatus or supraspinatus + subscapularis) rotator cuff tendons and measured the mechanical properties along the length of the long-head of the biceps tendon 4 and 8 weeks following injury. Cross-sectional area of the biceps was increased in the presence of a single rotator cuff tendon tear (by approximately 150%), with a greater increase in the presence of a multiple rotator cuff tendon tear (by up to 220%). Modulus values decreased as much as 43 and 56% with one and two tendon tears, respectively. Also, multiple tendon tear conditions involving the infraspinatus in addition to the supraspinatus affected the biceps tendon more than those involving the subscapularis and supraspinatus. Finally, biceps tendon mechanical properties worsened over time in multiple rotator cuff tendon tears. Therefore, the rat model correlates well with clinical findings of biceps tendon pathology in the presence of rotator cuff tears, and can be used to evaluate etiology and treatment modalities.
肩袖撕裂是导致关节负荷改变和功能缺陷的致残性疾病。临床上,已发现肱二头肌长头损伤与肩袖撕裂同时存在,且这种损伤被认为会随着撕裂尺寸的增加而加重。尽管其重要性,但关于肱二头肌的最佳治疗方法仍存在争议。这种疾病的动物模型将有助于进行对照研究,以探究该问题的病因和潜在的治疗策略。我们通过分离单个(冈上肌)和多个(冈上肌 + 冈下肌或冈上肌 + 肩胛下肌)肩袖肌腱在大鼠模型中制造肩袖撕裂,并在损伤后4周和8周测量肱二头肌长头沿长度方向的力学性能。在存在单个肩袖肌腱撕裂时,肱二头肌的横截面积增加(约150%),在存在多个肩袖肌腱撕裂时增加幅度更大(高达220%)。模量值在单肌腱撕裂和双肌腱撕裂时分别下降多达43%和56%。此外,除冈上肌外还涉及冈下肌的多肌腱撕裂情况对肱二头肌肌腱的影响大于涉及肩胛下肌和冈上肌的情况。最后,在多个肩袖肌腱撕裂中,肱二头肌肌腱的力学性能随时间恶化。因此,大鼠模型与肩袖撕裂时肱二头肌肌腱病理学的临床发现相关性良好,可用于评估病因和治疗方式。