Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675 Munich, Germany.
J Orthop Res. 2013 Feb;31(2):300-5. doi: 10.1002/jor.22211. Epub 2012 Aug 21.
The purpose was to evaluate histological changes of the supraspinatus tendon (SSP) after refixation under continuous growth factor application over 20 days in comparison to the native healing process. In a chronic rat tendon tear model (15 rats/group), a transosseous SSP refixation was performed and growth factors (control, G-CSF, b-FGF, combination) were continuously released into the subacromial space by an osmotic pump. Tendon healing was evaluated histologically by a modified MOVIN-Score, and Collagen I/III content was determined by immunohistology at 6 weeks. A modified MOVIN sum score showed significant lower counts for G-CSF and b-FGF in comparison to the control group (p = 0.050/p = 0.027) and the combined group (p = 0.050/p = 0.043). Collagen III was significantly reduced in the combined group compared to the control group (p = 0.028). Collagen I showed no significant differences. The Collagen I/III ratio was nearly doubled for b-FGF and the combined group compared to the control. At the study endpoint, 33% of pump dislocations were detected. The continuous application of both isolated growth factors (G-CSF/b-FGF) achieved improved tendon-remodeling. However, the continuous application via an osmotic pump showed a relative high dislocation rate when applied in the rat model.
目的是评估在连续 20 天应用生长因子后修复固定的冈上肌腱 (SSP) 的组织学变化，与自然愈合过程相比。在慢性大鼠肌腱撕裂模型中（每组 15 只大鼠），进行经骨 SSP 修复固定，并通过渗透泵持续将生长因子（对照、G-CSF、b-FGF、联合）释放到肩峰下间隙。通过改良 MOVIN 评分评估肌腱愈合情况，并在 6 周时通过免疫组织化学检测胶原 I/III 含量。改良 MOVIN 总分显示 G-CSF 和 b-FGF 组与对照组（p=0.050/p=0.027）和联合组（p=0.050/p=0.043）相比，计数明显较低。与对照组相比，联合组的胶原 III 明显减少（p=0.028）。胶原 I 无明显差异。b-FGF 和联合组的胶原 I/III 比值几乎是对照组的两倍。在研究终点，检测到 33%的泵脱位。单独应用两种生长因子（G-CSF/b-FGF）可改善肌腱重塑。然而，在大鼠模型中应用渗透泵持续应用时，脱位率相对较高。
