Department of Orthopedic Surgery, Kurume University, Kurume, Japan.
Arthroscopy. 2011 Sep;27(9):1173-9. doi: 10.1016/j.arthro.2011.03.078. Epub 2011 Jul 12.
The purpose was to evaluate the correlation between messenger RNA (mRNA) expression of collagen at the edge of the ruptured rotator cuff tendon and postoperative cuff integrity.
The edge of the ruptured tendon was sampled during open rotator cuff surgery in 12 patients with full-thickness rotator cuff tears (mean age, 58.2 years). The mean period from symptom onset was 9.3 months (range, 1 to 36 months), and the mean tear size was 4.1 cm. As controls, rotator cuff tendons with no gross rupture were taken from 5 fresh cadavers. Production of type I and type III collagen was examined by real-time reverse transcription polymerase chain reaction. By use of magnetic resonance imaging, postoperative cuff integrity was evaluated based on the classification of Sugaya et al. and then scored, ranging from 5 points for type I to 1 point for type V.
Looking at the mRNA of type I and type III collagen in tendons, we found that the expression of mRNA for both collagen types in ruptured tendons was significantly greater than in control tendons (P = .0462 for type I collagen and P = .0306 for type III collagen). Correlating the mRNA of type I and type III collagen with repaired cuff integrity on postoperative magnetic resonance imaging, we found a close relation between expression of mRNA for both collagen types and postoperative rotator cuff integrity (r = 0.63 [P = .038] for type I collagen and r = 0.626 [P = .03] for type III collagen). Furthermore, expression of type I collagen mRNA showed a significant inverse correlation with the period from symptom onset (r = -0.845, P < .0005).
This study showed that expression of mRNA for type I and type III collagen at the edge of the ruptured rotator cuff tendon was significantly correlated with postoperative cuff integrity and that mRNA expression for type I collagen was significantly associated with the period from symptom onset. These results may suggest that conservative treatment should not be prolonged if patients do not respond within a certain period.
Level III, prognostic case-control study.
评估撕裂肩袖肌腱边缘信使 RNA（mRNA）表达的胶原蛋白与术后肩袖完整性之间的相关性。
在 12 例全层肩袖撕裂患者的开放性肩袖手术中，从撕裂肌腱的边缘取样（平均年龄 58.2 岁）。从症状发作到手术的平均时间为 9.3 个月（范围 1 至 36 个月），平均撕裂大小为 4.1cm。作为对照，从 5 具新鲜尸体上取下无明显撕裂的肩袖肌腱。通过实时逆转录聚合酶链反应检查 I 型和 III 型胶原的产生。通过磁共振成像，根据 Sugaya 等人的分类评估术后肩袖完整性，然后评分，从 I 型的 5 分到 V 型的 1 分。
观察肌腱中 I 型和 III 型胶原的 mRNA，我们发现撕裂肌腱中两种胶原类型的 mRNA 表达均明显高于对照组（I 型胶原 P =.0462，III 型胶原 P =.0306）。将 I 型和 III 型胶原的 mRNA 与术后磁共振成像的修复肩袖完整性相关联，我们发现两种胶原类型的 mRNA 表达与术后肩袖完整性密切相关（I 型胶原 r = 0.63 [P =.038]，III 型胶原 r = 0.626 [P =.03]）。此外，I 型胶原 mRNA 的表达与症状发作时间呈显著负相关（r = -0.845，P <.0005）。
本研究表明，撕裂肩袖肌腱边缘 I 型和 III 型胶原的 mRNA 表达与术后肩袖完整性显著相关，I 型胶原的 mRNA 表达与症状发作时间显著相关。这些结果可能表明，如果患者在一定时间内没有反应，就不应延长保守治疗。
III 级，预后病例对照研究。
