冈上肌和冈下肌肌腱的相互作用：冈上肌腱全层撕裂对冈下肌肌腱应变的影响。
Interaction between the supraspinatus and infraspinatus tendons: effect of anterior supraspinatus tendon full-thickness tears on infraspinatus tendon strain.
机构信息
McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA 19104, USA.
出版信息
Am J Sports Med. 2009 Sep;37(9):1831-9. doi: 10.1177/0363546509334222. Epub 2009 May 29.
BACKGROUND
Rotator cuff tears are common and not well-understood shoulder problems. Structural and mechanical inhomogeneity of the supraspinatus tendon complicates accurate prediction of risk of tear propagation and may affect appropriate clinical treatment.
HYPOTHESIS
We propose that interactions between the supraspinatus and infraspinatus tendons are critical to load bearing at the glenohumeral joint and warrant investigation.
STUDY DESIGN
Controlled laboratory study.
METHODS
Principal strains in the infraspinatus tendon of cadaveric human shoulders were evaluated with increasing anterior full-thickness supraspinatus tendon tear sizes and loading to evaluate whether a mechanical interaction between the supraspinatus and infraspinatus tendons exists. A constant nominal load was attached to the infraspinatus throughout all experimental conditions.
RESULTS
Increasing supraspinatus tendon tear width from intact and 33% to 66% and increasing supraspinatus tendon load caused an increase in maximum and a decrease in minimum principal strain in the infraspinatus tendon. Increasing the supraspinatus tendon tear size from intact to 33% of the width had no significant effect on infraspinatus tendon strain.
CONCLUSION
Supraspinatus and infraspinatus tendons mechanically interact. The observed significant increase in maximum and decrease in minimum principal strain was concurrent in both the infraspinatus and supraspinatus tendons.
CLINICAL RELEVANCE
Changes in infraspinatus tendon strain associated with increases in supraspinatus tendon tear size and loading may shield a torn supraspinatus tendon from further injury or may have an effect on the load-bearing capacity of the infraspinatus tendon. Results also imply that the effect of a small tear that does not compromise the confluent region between the supraspinatus and infraspinatus tendon may be localized, eliminating its effect on infraspinatus tendon strain.
背景
肩袖撕裂是一种常见且尚未被充分了解的肩部问题。冈上肌腱的结构和力学非均质性使得对撕裂扩展风险的准确预测变得复杂，并可能影响到适当的临床治疗。
假设
我们假设冈上肌腱和冈下肌腱之间的相互作用对于盂肱关节的承重至关重要，值得进一步研究。
研究设计
对照实验室研究。
方法
通过增加全层前侧冈上肌腱撕裂的大小和加载来评估尸体人肩冈下肌腱的主应变，以评估冈上肌腱和冈下肌腱之间是否存在力学相互作用。在所有实验条件下，恒定的名义负荷都施加在冈下肌腱上。
结果
随着冈上肌腱撕裂宽度从完整和 33%增加到 66%以及冈上肌腱负荷的增加，冈下肌腱的最大主应变增加，最小主应变减小。将冈上肌腱撕裂大小从完整增加到 33%，对冈下肌腱应变没有显著影响。
结论
冈上肌腱和冈下肌腱在力学上相互作用。在冈下肌腱和冈上肌腱中观察到的最大主应变显著增加和最小主应变显著减小是同时发生的。
临床相关性
冈上肌腱撕裂大小和负荷增加引起的冈下肌腱应变变化可能会保护撕裂的冈上肌腱免受进一步损伤，或者可能对冈下肌腱的承重能力产生影响。结果还表明，不会影响冈上肌腱和冈下肌腱之间融合区域的小撕裂的影响可能是局部的，从而消除其对冈下肌腱应变的影响。
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