Orthopaedic Laboratory, Department of Molecular Medicine and Surgery, M1:02, The King Gustav V Research Building, Karolinska University Hospital 171 76 Stockholm, Sweden.
J Orthop Res. 2010 Jul;28(7):852-8. doi: 10.1002/jor.21066.
Achilles tendon ruptures are treated with an initial period of immobilization, which obstructs the healing process partly by a reduction of blood circulation. Intermittent pneumatic compression (IPC) has been proposed to enhance tendon repair by stimulation of blood flow. We hypothesized that daily IPC treatment can counteract the deficits caused by 2 weeks of immobilization post tendon rupture. Forty-eight Sprague-Dawley SD) rats, all subjected to blunt Achilles tendon transection, were divided in three equal groups. Group A was allowed free cage activity, whereas groups B-C were immobilized at the operated hindleg. Group C received daily IPC treatment. Two weeks postrupture the rats were euthanatized and the tendons analyzed with tensile testing and histological assessments of collagen organization and collagen III-LI occurrence. Immobilization significantly reduced maximum force, energy uptake, stiffness, tendon length, transverse area, stress, organized collagen diameter and collagen III-LI occurrence by respectively 80, 75, 77, 22, 47, 65, 49, and 83% compared to free mobilization. IPC treatment improved maximum force 65%, energy 168%, organized collagen diameter 50%, tendon length 25%, and collagen III-LI occurrence 150% compared to immobilization only. The results confirm that immobilization impairs healing after tendon rupture and furthermore demonstrate that IPC-treatment can enhance proliferative tendon repair by counteracting biomechanical and morphological deficits caused by immobilization.
跟腱断裂后首先采用固定治疗，其通过减少血液循环在一定程度上阻碍愈合过程。间歇性气动压迫（IPC）通过刺激血流来增强肌腱修复。我们假设每日 IPC 治疗可以抵消跟腱断裂后 2 周固定引起的缺陷。将 48 只 SD 大鼠（Sprague-Dawley）全部进行跟腱切断，随机平均分为 3 组。A 组可自由活动，B、C 组固定患肢。C 组接受每日 IPC 治疗。跟腱断裂 2 周后，处死大鼠，进行拉伸试验和胶原组织学评估，包括胶原排列和胶原 III-LI 出现情况。与自由活动相比，固定显著降低了最大力、能量吸收、刚度、跟腱长度、横截面积、应力、有序胶原直径和胶原 III-LI 出现分别为 80%、75%、77%、22%、47%、65%、49%和 83%。IPC 治疗使最大力提高了 65%，能量提高了 168%，有序胶原直径提高了 50%，跟腱长度提高了 25%，胶原 III-LI 出现提高了 150%。结果证实固定会损害跟腱断裂后的愈合，进一步证明 IPC 治疗可以通过抵消固定引起的生物力学和形态学缺陷来增强增殖性肌腱修复。
