Department of Orthopaedic Surgery , Lovisenberg Diaconal Hospital, Oslo , Norway .
Acta Orthop. 2013 Dec;84(6):565-70. doi: 10.3109/17453674.2013.858289. Epub 2013 Oct 31.
Rotator cuff tears are associated with secondary rotator cuff muscle pathology, which is definitive for the prognosis of rotator cuff repair. There is little information regarding the early histological and immunohistochemical nature of these muscle changes in humans. We analyzed muscle biopsies from patients with supraspinatus tendon tears.
Supraspinatus muscle biopsies were obtained from 24 patients undergoing arthroscopic repair of partial- or full-thickness supraspinatus tendon tears. Tissue was formalin-fixed and processed for histology (for assessment of fatty infiltration and other degenerative changes) or immunohistochemistry (to identify satellite cells (CD56+), proliferating cells (Ki67+), and myofibers containing predominantly type 1 or 2 myosin heavy chain (MHC)). Myofiber diameters and the relative content of MHC1 and MHC2 were determined morphometrically.
Degenerative changes were present in both patient groups (partial and full-thickness tears). Patients with full-thickness tears had a reduced density of satellite cells, fewer proliferating cells, atrophy of MHC1+ and MHC2+ myofibers, and reduced MHC1 content.
Full-thickness tears show significantly reduced muscle proliferative capacity, myofiber atrophy, and loss of MHC1 content compared to partial-thickness supraspinatus tendon tears.
肩袖撕裂与继发性肩袖肌肉病变相关,后者对肩袖修复的预后具有决定性意义。关于人类这些肌肉变化的早期组织学和免疫组织化学性质的信息很少。我们分析了患有冈上肌腱撕裂的患者的肌肉活检。
对 24 例行关节镜下部分或全层冈上肌腱撕裂修复的患者进行冈上肌活检。组织经福尔马林固定并进行组织学处理(评估脂肪浸润和其他退行性改变)或免疫组织化学处理(鉴定卫星细胞(CD56+)、增殖细胞(Ki67+)和主要含有 1 型或 2 型肌球蛋白重链(MHC)的肌纤维)。通过形态计量学确定肌纤维直径和 MHC1 和 MHC2 的相对含量。
两组患者(部分撕裂和全层撕裂)均存在退行性变化。全层撕裂患者的卫星细胞密度降低,增殖细胞减少,MHC1+和 MHC2+肌纤维萎缩,MHC1 含量减少。
与部分厚度的冈上肌腱撕裂相比,全层撕裂显示出明显降低的肌肉增殖能力、肌纤维萎缩和 MHC1 含量减少。