Orthopaedic Robotics Laboratory, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Orthop Res. 2014 Oct;32(10):1283-9. doi: 10.1002/jor.22675. Epub 2014 Jul 2.
Rotator cuff tears are a significant clinical problem. Tears in the anterior supraspinatus might behave differently compared to central tears due to differences in regional structural properties. The objective of this study was to determine strain distributions for anterior supraspinatus tendon tears and the relationship to tear propagation during cyclic loading. It was hypothesized that highest maximum principal strain would be posterior to the tear, and tears would propagate in the direction of the maximum principal strain. Eight human cadaveric supraspinatus tendons with surgically created small tears in the anterior third were tested with increasing levels of cyclic loads. The position of strain markers was recorded on the bursal surface of the tendon to calculate strain. Tendons reached a 2 cm critical tendon retraction at 580 ± 181 N. Largest strains were found medial and posterior to the tear (26.1 ± 9.4%). In five tendons, the strain direction for the initial (114 ± 28°) and final loading sets (86 ± 20°) indicated the strain direction shifted from an anterior to posterior orientation (p < 0.01), corresponding to the direction of tear propagation. Based on the results, anterior supraspinatus tears would remain isolated to the supraspinatus tendon during activities of daily living.
肩袖撕裂是一个重要的临床问题。由于区域结构特性的不同，前上盂肱肌腱撕裂的表现可能与中央型撕裂不同。本研究的目的是确定前上盂肱肌腱撕裂的应变分布及其在循环加载过程中与撕裂扩展的关系。假设最大主应变将位于撕裂的后部，并且撕裂将沿最大主应变的方向扩展。对 8 个人体尸体肩袖的前 1/3 处有手术造成的小撕裂进行了测试，施加了不同水平的循环载荷。在肌腱的肩峰下表面记录应变标记的位置以计算应变。肌腱在 580±181N 时达到 2cm 的临界肌腱回缩。最大应变位于撕裂的内侧和后部（26.1±9.4%）。在 5 根肌腱中，初始（114±28°）和最终加载组（86±20°）的应变方向表明应变方向从从前到后的方向发生了变化（p<0.01），与撕裂扩展的方向相对应。根据结果，在前上盂肱肌腱撕裂在日常生活活动中仍将局限于肩袖肌腱。
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