Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, U.S.A.
Arthroscopy. 2010 Nov;26(11):1456-62. doi: 10.1016/j.arthro.2010.02.025. Epub 2010 Aug 21.
The purpose of this study was to determine whether suture could be coated with recombinant human platelet-derived growth factor BB (rhPDGF-BB) and whether the coated suture would improve histologic scores and biomechanical strength of sheep rotator cuff repairs.
FiberWire sutures (Arthrex, Naples, FL) were dip coated in a collagen-rhPDGF-BB solution. Coating was confirmed by use of enzyme-linked immunosorbent assay. Rotator cuff tears were created in 18 sheep. The tendons were wrapped in Gortex (Gore Medical, Flagstaff, AZ) and allowed to scar for 2 weeks. Tendons were then repaired to bone by use of standard anchors loaded with either rhPDGF-BB-coated sutures or uncoated sutures. Gross examination, histologic analysis, and biomechanical testing were performed 6 weeks after repair.
Enzyme-linked immunosorbent assay confirmed successful loading of the growth factor onto the sutures. Gross examination showed well-healed tendon-to-bone interfaces in both rhPDGF-BB-augmented repairs and controls. Histologic analysis using a semiquantitative rating scale showed improved tendon-to-bone healing in the rhPDGF-BB-augmented repairs. There was no significant difference in the ultimate load to failure of rhPDGF-BB-augmented rotator cuff repairs compared with standard suture repairs at 6 weeks after repair.
We were able to coat No. 2 FiberWire with rhPDGF-BB. At short-term follow-up, rhPDGF-BB-coated sutures enhanced histologic scores of sheep rotator cuff repairs; however, ultimate load to failure was equivalent to standard suture repairs.
rhPDGF-BB-coated sutures seem to produce a more histologically normal tendon insertion.
本研究旨在确定缝线可否包被重组人血小板衍生生长因子 BB（rhPDGF-BB），以及包被缝线可否改善羊肩袖修复的组织学评分和生物力学强度。
纤维线（Arthrex，那不勒斯，佛罗里达州）采用胶原-rhPDGF-BB 溶液进行浸涂。采用酶联免疫吸附试验（ELISA）确认包被。在 18 只绵羊中制造肩袖撕裂。将肌腱用 Gortex（戈尔公司，弗拉格斯塔夫，亚利桑那州）包裹并允许其瘢痕化 2 周。然后，通过使用标准的锚定器将肌腱修复至骨骼，这些锚定器装载有 rhPDGF-BB 包被缝线或未包被缝线。在修复后 6 周进行大体检查、组织学分析和生物力学测试。
ELISA 证实成功地将生长因子加载到缝线中。大体检查显示，在 rhPDGF-BB 增强修复和对照组中，肌腱与骨的界面均愈合良好。采用半定量评分量表进行组织学分析显示，rhPDGF-BB 增强修复的肌腱与骨愈合得到改善。在修复后 6 周时，rhPDGF-BB 增强的肩袖修复与标准缝线修复的最终失效负载无显著差异。
我们能够将 No. 2 纤维线包被 rhPDGF-BB。在短期随访中，rhPDGF-BB 包被缝线增强了羊肩袖修复的组织学评分；然而，最终失效负载与标准缝线修复相当。
rhPDGF-BB 包被缝线似乎产生了更组织学正常的肌腱插入。
