McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, 424 Stemmler Hall, Philadelphia, PA 19104-6081, USA.
J Biomech. 2010 Nov 16;43(15):2904-7. doi: 10.1016/j.jbiomech.2010.07.035. Epub 2010 Aug 16.
Biceps tendon pathology is a common clinical problem often seen in conjunction with rotator cuff tears. A previous study found detrimental changes to biceps tendons in the presence of rotator cuff tears in a rat model. Therefore, the objective of this study was to utilize this model along with models of altered loading to investigate the effect of altered loading on the initiation of these detrimental changes. We created supraspinatus and infraspinatus rotator cuff tears in the rat and followed these tears with either increased or decreased loading. Mechanical properties were determined along the length of the biceps tendon 4 and 8 weeks following injury. At the insertion site, stiffness increased with decreased loading, while detrimental changes were seen with increased loading 4 weeks following detachments. Increased loading resulted in decreased mechanical properties along the entire tendon length at both time points. Decreased loading resulted in both increased and decreased tendon properties at different regions of the tendon at 4 weeks, but by 8 weeks, there were no differences between decreased loading and detachment alone. We could not conclude where changes begin in the tendon with altered loading, but did demonstrate that regional differences exist. These results support that there is an effect of altered loading, as decreased loading resulted in variable changes at 4 weeks that were no different from detachment alone by 8 weeks, and increased loading resulted in detrimental properties along the entire length at both 4 and 8 weeks.
肱二头肌肌腱病变是一种常见的临床问题,常与肩袖撕裂同时发生。先前的一项研究在大鼠模型中发现肩袖撕裂存在时肱二头肌肌腱有不利变化。因此,本研究的目的是利用该模型以及改变负荷的模型,研究改变负荷对这些不利变化发生的影响。我们在大鼠中制造了冈上肌和冈下肌肩袖撕裂,并在撕裂后增加或减少负荷。在损伤后 4 周和 8 周时,沿肱二头肌肌腱的长度确定力学性能。在插入部位,随着负荷的减少,刚度增加,而在附着后 4 周,随着负荷的增加,出现了不利变化。增加的负荷导致在两个时间点整个肌腱长度的机械性能降低。在 4 周时,减少负荷导致肌腱的不同区域的肌腱特性增加和减少,但到 8 周时,减少负荷与单独分离之间没有差异。我们无法确定在改变负荷的情况下肌腱的变化从哪里开始,但确实表明存在区域差异。这些结果支持改变负荷的影响,因为在 4 周时减少负荷导致的变化在 8 周时与单独分离没有区别,而在 4 周和 8 周时,增加负荷导致整个长度的肌腱出现不利特性。