Phipatanakul Wesley P, Petersen Steve A
Department of Orthopaedic Surgery, Loma Linda University, Loma Linda, CA 92354, USA.
Am J Orthop (Belle Mead NJ). 2009 Nov;38(11):572-5.
In this prospective study, we evaluated the efficacy of using porcine small intestine submucosa (SIS) xenograft to augment the repair of massive rotator cuff tears. Our hypothesis was that SIS xenograft would help restore tendon tissue in the human model, as has been shown in several animal studies. Eleven patients were followed clinically for a mean of 26 months (range, 14-38 months). Mean University of California Los Angeles end-result scores improved from 13.9 before surgery to 25.7 after surgery, American Shoulder and Elbow Surgeons scores improved from 36.3 to 71.8, and the visual analog scale pain score decreased from 6.6 to 2.0. All findings were statistically significant (P<.01). At a mean of 25 months after surgery, magnetic resonance arthrography (MRA) showed the repairs partially or completely intact in 44% of shoulders. Intact repairs were thin and wispy. There were 3 complications, which included 1 infection and 2 localized skin reactions that resolved spontaneously. SIS xenograft did not reconstitute rotator cuff tissue or add to the quality of the rotator cuff repair. Given clinical concerns about localized reactions in this series and suboptimal MRA findings, use of SIS xenograft to augment rotator cuff repairs is not recommended.
在这项前瞻性研究中，我们评估了使用猪小肠黏膜下层（SIS）异种移植物增强巨大肩袖撕裂修复效果的有效性。我们的假设是，正如在多项动物研究中所显示的那样，SIS异种移植物将有助于在人体模型中恢复肌腱组织。对11例患者进行了平均26个月（范围为14 - 38个月）的临床随访。加利福尼亚大学洛杉矶分校的平均最终结果评分从术前的13.9提高到术后的25.7，美国肩肘外科医师协会评分从36.3提高到71.8，视觉模拟量表疼痛评分从6.6降至2.0。所有结果均具有统计学意义（P<0.01）。术后平均25个月时，磁共振关节造影（MRA）显示44%的肩部修复部分或完全完整。完整的修复组织薄且呈细丝状。有3例并发症，包括1例感染和2例自发缓解的局部皮肤反应。SIS异种移植物未能重建肩袖组织，也未提高肩袖修复的质量。鉴于本系列研究中对局部反应的临床担忧以及MRA结果不理想，不建议使用SIS异种移植物增强肩袖修复。
